OBJECTIVE Of many critical care regimens, the management of physiological disturbances in serum is particularly drawing an attention in conjunction with patient outcome. The aim of this study was to assess the association of serum biochemical markers with mortality in head trauma patients with decompressive craniotomy. METHODS Ninety six patients with acute subdural hematoma underwent decompr...

Background: The aim of the present study was to explore clinical effect and predict prognosis severe craniocerebral injury patients with decompressive craniectomy by combining transcranial Doppler (TCD) invasive intracranial pressure (ICP).

Ultrasound may be a useful tool to evaluate intracranial abnormalities in critically ill patients undergoing decompressive craniectomy. We present a multiple trauma patient who had undergone craniectomy and in whom recurrent intraventricular hemorrhage and patterns of cerebral blood flow were rapidly detected by ultrasound.

Lumbar puncture is performed routinely for diagnostic and therapeutic purposes in idiopathic intracranial hypertension, despite lumbar puncture being classically contraindicated in the setting of raised intracranial pressure. We report the case of a 30-year-old female with known idiopathic intracranial hypertension who had cerebellar tonsillar herniation following therapeutic lumbar puncture. M...

OBJECTIVE Malignant middle cerebral artery (MCA) infarction occurs in 10% of all ischemic strokes and these severe strokes are associated with high mortality rates. Recent clinical trials demonstrated that early decompressive craniectomy reduce mortality rates and improves functional outcomes in healthy young patients (less than 61 years of age) with a malignant infarction. The purpose of this ...

OBJECTIVE We compared the effect of decompressive craniectomy between patients < 65 and ≥ 65 years age and investigated prognostics factors that may help predict favorable outcome in acute stroke patients undergoing decompressive surgery. MATERIALS AND METHODS 52 patients diagnosed with acute middle cerebral artery (MCA) territory infarction that underwent decompressive craniectomy were retro...

Massive cerebral infarction is often accompanied by early death, secondary to brain edema and trans-tentorial herniation. Several reports indicate beneficial effects of decompressive craniectomy in this situation, but the efficacy of this procedure is still a matter of debate. A n experimental study in a period of3 years was done on2 3 patients with brain edema due to massive cerebral infa...

BACKGROUND It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and refractory raised intracranial pressure. METHODS From December 2002 through April 2010, we randomly assigned 155 adults with severe diffuse traumatic brain injury and intracranial hypertension that was refractory to first-tier therapies to undergo eithe...

Cerebral venous sinus thrombosis (CVST) may occur following head trauma and contribute to intracranial hypertension that mandates immediate action. Anticoagulant therapy is the first line of treatment in CVST but may not be applicable in patients with head trauma. Here, we report on the treatment of 2 patients with CVST. In 1 patient, there was an attempt to perform thrombectomy and thrombolysi...

Large hemispheric infarctions have malignant course and constitute a major cause of severe morbidity and mortality after stroke. The medical management is usually not effective in these cases. Decompressive craniectomy is a salvage therapy for medically refractory ICP. This paper discusses the merits and demerits of decompressive craniectomy for large hemispheric infarctions. Hemicraniectomy is...