Decompressive Craniectomy Following Brain Injury: Factors Important to Patient Outcome

ABSTRACT

Background: Decompressive craniectomy (DC) is often performed as an empirical lifesaving measure to protect the injured brain from the damaging effects of propagating oedema and intracranial hypertension. However; there are no clearly defined indications or specified guidelines for patient selection for the procedure. Aims: To evaluate outcome determinants and factors important in patient selection for the procedure. Methods: We reviewed the literature on DC; including single case reports and reported case series; to identify factors affecting outcome following the procedure; as well as its pitfalls and associated complications. Results: Glasgow coma score of 8 and above; age less than 50 years and early intervention were found to be among the most significant determinants of prognosis. Conclusion: Improving patient selection for DC may be expected to further improve the outcome following the procedure in severely brain-injured patients