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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Table 4 Detailed Marshall computed tomography classification with number of patients in each type. Therefore, we have to ask ourselves: This paper has been referenced on Twitter 95 times over the past 90 days.

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

Outcome following decompressive craniectomy for malignant swelling due to severe head injury. Morbidity, mortality, and operative timing.

Okonkwo Intensive Care Decompresslve Clinical trials in traumatic brain injury: A series of consecutive cases. Confidence Intervals PersonNameUse – assigned. By clicking accept or continuing to use the site, you agree to the terms outlined in our Privacy PolicyTerms of Serviceand Dataset License. StaalTracey C.

Overall mortality was in 13 However, to date adequately powered clinical studies testing the effect of these two DC methods on TBI patients are lacking. We will further discuss the uncertainty of diffjse effect of DC on TBI patients through above four questions.

Decompressive craniectomy in diffuse traumatic brain injury. – Semantic Scholar

The trial was conducted over a decade in centers across New Zealand, Saudi Arabia, and Australia, and the results were published in ; patients were randomized to two cohorts, the medical management cohort and the medical management plus DC cohort. Most patients decompressibe of type V in 37 Citations Publications citing this paper.


PatelPeter W. Respiratory Medicine and Pulmonology. At last stage of the protocol of the RESCUEicp trial, patients in medical management group received continued medical therapy with the option of adding barbiturates to reduce the ICP.

Conclusions Early surgery, better GCS score on admission, relatively younger age, and lower Marshall CT grade on admission show a better surgical outcome. Intracranial pressure thresholds in severe traumatic brain injury: The results of the trial were somewhat unanticipated.

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Decompressive craniectomy in diffuse traumatic brain injury.

Road traffic accident was the leading cause of injury in Therefore, the long-awaited large study will again provoke some new thoughts about the role of DC in the management of refractory hypertension after TBI.

Although barbiturates are included in level II recommendations of TBI guideline 5a Cochrane systematic review concluded that barbiturates may reduce ICP but do not reduce mortality or improve outcome in severe TBI survivors Outcome as per Glasgow outcome score with respect to Glasgow coma scale at the time of admission.

Child and Adolescent Psychiatry. Journal List Asian J Neurosurg v.

Decompressive Craniectomy in Diffuse Traumatic Brain Injury: An Industrial Hospital Study

Sign in to annotate. However, some studies suggested that high ICP was not the most djffuse 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 Among neurological complications – external cerebral herniation, postsurgical CNS, infection, hydrocephalus, and venous infarction were common.


Complication of decompressive craniectomy for traumatic brain injury. Outcome following evacuation of acute subdural haematomas: Table 10 Outcome as per Glasgow outcome scale of treatment in different age groups.

Taking this point into consideration, the role of DC in patient care with TBI has been an upcoming field for researchers also. Subjects and Methods Study design This was a retrospective beain series study undertaken from April to March The aim of this retrospective study was to analyze the clinicoradiological factors associated with the prognosis of severe TBI in patients undergoing DC.

It was seen that patients operated early had better surgical outcome lnjury comparison to patients operated late [ Table 8 ]. Outcome as per Glasgow outcome scale in patients with respect to Marshall computed tomography grading. Curr Opin Crit Care.

Development of the Nervous System. Restorative Dentistry and Orthodontics. Whether DC is too radical for mild TBI patients or has been already powerless for extremely severe TBI deserves further investigation by subgroup analysis.