Refractory traumatic intracranial hypertension: The role of decompressive craniectomy

Abstract

Traumatic brain injury according to the World Health Organization estimates that by 2020 will be the third leading cause of morbidity and mortality worldwide. Intracranial hypertension refractory to medical management is the cause of increased mortality in neurotrauma. There are various measures to control intracranial hypertension, including surgical. Decompressive craniectomy has been routinely used to treat intracranial hypertension secondary to cerebral infarction, subarachnoid hemorrhage, intracerebral hemorrhage and trauma. We review the literature to describe the mechanisms, types and indications for this procedure.