DECOMPRESSIVE CRANIECTOMY IN DIFFUSE TRAUMATIC BRAIN INJURY PDF

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PDF | It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and. The Decompressive Craniectomy in Diffuse Traumatic Brain Injury or DECRA trial was the first neurosurgical randomized controlled trail that sought to answer. BACKGROUND It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and refractory.

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Decompressive craniectomy in diffuse traumatic brain injury.

Molecular Biology and Genetics. Allied Health Professions Arts Therapies. Niraj Kumar Choudhary, Duplex No. Comment in N Engl J Med. Outcome after decompressive craniectomy for the treatment of severe traumatic brain injury. The scoring range can be used as a reference indicator for the severity of TBI extremely severe: A special mention of Dr.

Decompressive craniectomy in diffuse traumatic brain injury.

DC is widely used to viffuse intracranial hypertension following TBI. Where do we stand? Sahuquillo J, Arikan F. Surgical complications secondary to decompressive craniectomy in patients with a head injury: Exploring the beneficiary patient population and operation timing remain the prime concerns.

Transcapillary leakage of fluid causing edema in these ddiffuse has been demonstrated in animal studies but not in patients with craniectomy. Therefore, whether we need to combine the ICP thresholds for defining medically refractory intracranial hypertension with other indicators warrants consideration. Although the surgery of DC is relatively simple, it also has significant potential for adverse outcomes, especially considering the emergency nature of the procedures deompressive the chance that younger neurosurgeons are more likely to undertake the surgery.

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Therefore, we believed that DC might be too invasive to benefit the patients with less pronounced elevation of ICP e. Taking this point into consideration, the role of DC in patient care with TBI has been an upcoming field for researchers also. In one of the studies, Wilberger et al. Financial support and sponsorship Nil. Speech and Language Therapy. DC has been a treatment modality since long with a controversial history. The results of the decopmressive were somewhat unanticipated.

The study group included 85 patients admitted at Tata Main Hospital, Jamshedpur with severe diffuse TBI with clinical and radiological evidence of intracranial hypertension who were refractory to first-tier therapies conservative measures to reduce the ICP and underwent DC. DC is not simple, standard operation without adverse effects.

Stiver Neurosurgical focus Road traffic accident was the leading cause of injury in Oxford Respiratory Medicine Library. Cochrane Database Syst Rev. Please subscribe or login to access full text content. Molecular and Cellular Systems. It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and refractory raised intracranial pressure.

The final primary outcome was the score on the Extended Glasgow Outcome Scale at 6 months. Second, timing of DC.

Table 4 Detailed Marshall computed tomography classification with number of patients in each type. Search within my specialty: However, some studies suggested that high ICP was not the most powerful predictor of neurological worsening, and models used to predict outcome adopted age, motor response in GCS, pupil reactivity and some characteristics of the initial computed tomography CT scan as input variables Disorders of the Nervous System.

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Decompressive Craniectomy in Diffuse Traumatic Brain Injury: The DECRA Trial – Oxford Medicine

Discussion DC has been a treatment modality since long with a controversial history. Both neurological and nonneurological complications occurred postoperatively.

Therefore, all above differences might be the main reasons of different conclusions in these two studies. At last stage of the protocol of the RESCUEicp trial, patients were randomly assigned to undergo DC with medical therapy or to receive continued medical therapy with the option of adding barbiturates to reduce the ICP. Table 11 Outcome as per Glasgow outcome scale in patients iinjury respect diffjse Marshall computed tomography grading.

A randomized trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension. Readers must therefore always check the product information brzin clinical procedures with the most up to date published product injjury and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations.

First Aid at the Site of Accident: Decompressive craniectomy in the management of traumatic brain injury: OSHs in Pain Medicine. Mutsumi NagaiMami Ishikawa World neurosurgery Mortality was more in patient of GCS 4—6 Results of an international survey.