ArticleWorld neurosurgery: X2024
Intracranial pressure changes in traumatic brain injury patients undergoing unilateral decompressive craniectomy with dural expansion.
Article in World neurosurgery: X, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Surgical Management of Traumatic Brain Injury Based on Intracranial Compliance: Toward Personalized Decision-Making.Brain sciences · 2026Review
- Case Report: Stepwise quantitative assessment of intraoperative intracranial pressure after perforation, craniotomy, dural incision, and hematoma removal in acute subdural hematoma.Frontiers in surgery · 2026Article
- Prognostic value of early intracranial pressure curve following surgical decompression: A machine learning analysis.Brain & spine · 2026Article
- Cranioplasty with a 3D-printed titanium implant for post-decompressive craniectomy syndrome: A case report.Surgical neurology international · 2026Article
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Authors and funding
6 authors.
Funding
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Abstract
Background: The aim of this study is to assess the ICP changes induced by a unilateral fronto-temporo-parietal DC with dural expansion after moderate to severe TBI. The effect of different bone flap sizes on ICP and the neurological outcomes were also evaluated after the decompressive surgery. Methods: 52 TBI patients with clinical and radiological evidences of increased ICP were included in this prospective study. All patients received unilateral fronto-temporo-parietal DC with dural expansion and ventriculostomy at contralateral Kocher's point. Postoperatively, ICP values and the largest antero-posterior (AP) diameter of bone flap removed was measured, and the clinical outcomes were assessed using Extended Glasgow Outcome Scale (GOS-E) at discharge and 6 months after DC. Results: The median ICP significantly decreased with an average of 56.7 % reduction from the initial opening ICP. Similar ICP changes were observed in all groups. This study also found that the large bone flap group (AP diameter >15 cm) demonstrated better postoperative ICP control as compared to the small bone flap group (AP diameter 12-15 cm), although not statistically significant. The SDH and cerebral swelling groups did better in the GOS-E at 6 months after TBI compared with cerebral contusion group. Conclusion: The ICP reduction in moderate to severe TBI patients undergoing unilateral fronto-temporo-parietal DC with dural expansion occurred in accordance with decompressive steps, regardless of intracranial lesions and the surgical procedure should be performed with the bone flap size of at least 12 cm in AP diameter for adequate and sustained ICP control.
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