Treatment

Decompressive Craniectomy

Overview

Decompressive craniectomy is a surgical procedure performed to relieve pressure on the brain caused by swelling. In this decompressive craniectomy surgery, a part of the skull is temporarily removed to allow the brain to expand without being compressed. This procedure is often used in emergencies to prevent brain damage and improve survival chances, especially in cases of traumatic brain injury.

Why is Decompressive Craniectomy Required?

This surgery is usually needed when there is severe brain swelling due to conditions like:

• Traumatic brain injury (TBI): A major reason for decompressive craniectomy in traumatic brain injury is to prevent life-threatening pressure buildup.
• Stroke: A large stroke can cause swelling requiring craniectomy decompression to protect brain function.
• Chiari malformation: In some cases, chiari malformation decompressive craniectomy is performed to relieve pressure.
• Brain hemorrhage: Uncontrolled bleeding in the brain may cause swelling, making surgery necessary.

If left untreated, excessive brain pressure can lead to permanent brain damage or death.

Key Advantages of Decompressive Craniectomy

• Increases decompressive craniectomy survival rate by reducing brain pressure.
• Prevents brain herniation which can be fatal.
• Reduces long-term neurological damage.
• Improves recovery in severe brain injury cases.
• Helps restore normal brain function in many patients.

How Should You Prepare Before Decompressive Craniectomy Treatment?

If decompressive craniectomy surgery is planned, doctors may guide you through preparation steps, such as:

• Stopping certain medications that can increase bleeding risk.
• Undergoing imaging tests like CT scans or MRIs to assess brain swelling.
• Fasting for a few hours before surgery if required.
• Discussing potential outcomes and life after decompressive craniectomy with the doctor.

In emergencies, decompressive craniectomy procedure is performed immediately without prior preparation.

How is Decompressive Craniectomy Performed?

• Anesthesia: The patient is given general anesthesia.
• Incision & Skull Removal: A surgeon makes an incision in the scalp and removes a part of the skull (bone flap). This could be on the left side (left FTP decompressive craniectomy) or another area based on brain swelling location.
• Swelling Relief: The exposed brain area is allowed to expand, reducing dangerous pressure.
• Closure: The skin is stitched back, and the bone flap is stored for future reattachment.

What to Expect?

1. Before the Procedure

• You may undergo imaging tests.
• Doctors will assess brain swelling severity.
• If it is an emergency, the surgery is performed immediately.

2. During the Procedure

• The surgeon carefully removes a section of the skull.
• Brain swelling is monitored to prevent complications.
• Surgery duration varies based on severity but usually lasts a few hours.

3. After the Procedure

• Patients are monitored in the ICU for brain function and recovery.
• Rehabilitation and therapy may be needed.
• Later, the skull bone may be reattached in another surgery.

Risks and Potential Complications

While decompressive craniectomy procedure is often life-saving, there are potential risks:

• Infection at the surgical site.
• Brain swelling complications.
• Bleeding or stroke.
• Seizures in some cases.
• Need for additional surgeries.
• Changes in cognitive or motor functions.

Results/Outcomes

• Saves Lives: A crucial life-saving procedure for patients with severe brain swelling.
• Reduces Brain Pressure: Prevents permanent brain damage by allowing the brain to expand safely.
• Improves Recovery Chances: Many patients regain significant brain function with rehabilitation.
• Prevents Brain Herniation: Stops life-threatening complications caused by high pressure inside the skull.
• Better Long Term Outcomes: With proper care, many patients can return to daily activities.
• Rehabilitation is Key: Physical and cognitive therapy can enhance recovery and restore normal function.
• Varies by Condition: Recovery depends on factors like age, severity of injury, and overall health.