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2019, Number 4

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Rev Cub Med Int Emerg 2019; 18 (4)

Debates about decompressive craniectomy in traumatic intracranial hypertension

Sierra BEM

Language: Spanish
References: 32
Page: 1-16
PDF size: 267.71 Kb.


ABSTRACT

Introduction: Intracranial hypertension negatively influences the prognosis of severe head trauma. Decompressive craniectomy is a treatment option.
Objective: To describe the debates about the use of decompressive craniectomy in traumatic intracranial hypertension.
Acquisition of evidence: A descriptive study was carried out based on a bibliographic review in PubMed, Scielo and EBSCO. We selected Spanish or English articles addressing controversial aspects about the use of decompressive craniectomy in the management of traumatic intracranial hypertension, which were published mainly in the last five years. The historical-logical, analysis-synthesis and inductive-deductive methods were used.
Results: The use of decompressive craniectomy, as treatment of refractory intracranial hypertension, is a conservative therapy in traumatic brain injury. Despite the heterogeneity of the results obtained with this treatment, it has been shown that mortality decreases compared to patients treated conservatively. In addition, in the studies in which it has been early used, the incidence of vegetative states has improved.
Conclusions: Although there are debateable aspects in the reviewed research on this treatment, decompressive craniectomy is concluded to be useful, if early applied, in patients with traumatic intracranial hypertension.


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