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The Value of Decompressive Craniectomy in Traumatic Brain Injury

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Evidence for Neurosurgery

Abstract

Intracranial hypertension and brain swelling are well recognised secondary insults following traumatic brain injury (TBI), which are associated with increased mortality and worse outcomes. Decompressive craniectomy refers to the practice of removing a large bone flap and opening the underlying dura. By “opening the box”, the intracranial pressure is lowered and the risk of herniation can be avoided, although not completely eliminated. This chapter aims to critically appraise the existing evidence base in order to define the role of decompressive craniectomy following TBI.

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Acknowledgements

Angelos Kolias and Peter Hutchinson are supported by the NIHR Global Health Research Group on Neurotrauma, which was commissioned by the NIHR using Official Development Assistance (ODA) funding (project 16/137/105). The views expressed in this publication are those of the authors and not necessarily those of the NHS, National Institute for Health Research or the Department of Health.

Conflicts of Interest

Angelos Kolias and Peter Hutchinson were involved as investigators with the RESCUEicp trial. All authors are involved as investigators with the RESCUE-ASDH trial.

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK

    Angelos G. Kolias & Peter J. Hutchinson

  2. NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK

    Angelos G. Kolias & Peter J. Hutchinson

  3. Department of Neurosurgery, University Hospital of Larissa and University of Thessaly, Larissa, Greece

    Athanasios Paschalis & Kostas N. Fountas

Authors
  1. Angelos G. Kolias
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  2. Athanasios Paschalis
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  3. Kostas N. Fountas
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  4. Peter J. Hutchinson
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Corresponding author

Correspondence to Angelos G. Kolias .

Editor information

Editors and Affiliations

  1. Radboud University Medical Center, Nijmegen, The Netherlands

    Ronald H. M. A. Bartels

  2. Radboud University Medical Center, Nijmegen, The Netherlands

    Maroeska M. Rovers

  3. Radboud University Medical Center, Nijmegen, The Netherlands

    Gert P. Westert

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Kolias, A.G., Paschalis, A., Fountas, K.N., Hutchinson, P.J. (2019). The Value of Decompressive Craniectomy in Traumatic Brain Injury. In: Bartels, R., Rovers, M., Westert, G. (eds) Evidence for Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-16323-5_2

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  • DOI: https://doi.org/10.1007/978-3-030-16323-5_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16322-8

  • Online ISBN: 978-3-030-16323-5

  • eBook Packages: MedicineMedicine (R0)

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