Contemporary Re-evaluation of Decompressive Craniectomy in the Treatment of Serious Cranioencephalic Trauma

Abstract

The health complications that are responsible for most deaths from trauma worldwide are traumatic brain injury (TBI) and intracranial hypertension (ICH), refractory to neurointensive and neuroprotective management, representing a significant problem in public health. In this context, decompressive craniectomy, a technique that had fallen into disuse in the past, has regained relevance over the last decade due to its outstanding results in the management of intracranial hypertension, being used systematically in cases of severe head trauma and other causes of ICH. Given the current epidemiology of traumatic brain injury, a comprehensive review of the scientific literature is essential to understand the pathophysiological mechanisms involved in traumatic brain injury. Early identification and proper management of intracranial hypertension are crucial to prevent or minimize irreversible brain damage and improve long-term outcomes.