Optimizing Traumatic Brain Injury Recovery: Exploring the Advantages and Results of Decompressive Craniectomy.

Abstract

Traumatic brain injury (TBI) causes significant mortality and morbidity across regions, imposing a substantial socioeconomic burden on societies. A major complication that can arise is uncontrolled intracranial pressure (ICP). Several strategies exist for reducing ICP in TBI patients, including head elevation, mannitol administration, and hyperventilation. Decompressive craniectomy (DC) is a therapeutic approach employed to lower ICP. This technique offers immediate and permanent relief from elevated ICP, although there are ongoing debates regarding its beneficial use and appropriate indications for patients with increased ICP. The objective of this review was to assess variations in surgical technique, timing of the procedure, and patient characteristics associated with DC. Through the evaluation of clinical and radiologic data concerning DC in patients with elevated ICP, it was revealed that while DC provides numerous benefits, it also carries a significant risk of mortality and morbidity. Furthermore, we observed that factors such as age, initial Glasgow Coma Scale (GCS) score, pupil response, and the time interval between injury and DC can serve as predictors for the procedure's outcomes. Based on our findings, we recommend conducting further trials to shed light on the use of DC in TBI patients.