Dekompressive Kraniektomie in der Neurotraumatologie

Decompressive Craniectomy in Neurotraumatology. Decompressive craniectomies (uni-/bilateral hemicranietomy, bifrontal craniectomy) for relief of compressed cerebral structures following severe traumatic brain injury are complex neurosurgical procedures to lower elevated intraparenchymal pressure. This review highlights historical backgrounds, indications, technical aspects of surgery, and ongoing scientific discussions. Decompressive craniectomy is an emergency operation in case of severe traumatic primary brain injury as well as a second-line therapy to prevent secondary brain damage due to refractory elevated intracranial hypertension. Technical aspects of sufficient decompression are described. Complications and surgical morbidity are reviewed. The value of decompressive craniectomy for functional outcome of severe traumatic brain injury is discussed including the already finished DECRA trial and the ongoing RESCUEicp trial. J Neurol Neurochir Psychiatr 2015; 16 (3): 103–10.