Singh Chahat, Gharde Pankaj, Iratwar Sandeep, Verma Prince, Triwedi Bhushan
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Neurosurgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jul 19;16(7):e64923. doi: 10.7759/cureus.64923. eCollection 2024 Jul.
Decompressive craniectomy (DC) is a neurosurgical strategy that expels a parcel of the cranium to relieve pressure on a swollen or herniating brain. This review article explores the history of DC, from its ancient roots in trepanning to its contemporary applications. It then examines the mechanisms by which DC reduces intracranial pressure (ICP) and improves cerebral blood flow. The article highlights the efficacy of DC in treating patients with severe traumatic brain injury (TBI), stroke, and other conditions that cause increased ICP. However, it also acknowledges the potential complications of DC, such as infection and bleeding. The ethical considerations surrounding DC are explored in detail, particularly the challenging decision-making process for patients who are unable to give consent. A specific focus is given to the use of DC in pediatric patients, where the developing brain is especially vulnerable to pressure changes.
减压颅骨切除术（DC）是一种神经外科手术策略，即移除部分颅骨以减轻肿胀或疝出的大脑所承受的压力。这篇综述文章探讨了DC的历史，从其古代钻孔术的根源到当代应用。然后研究了DC降低颅内压（ICP）并改善脑血流的机制。文章强调了DC在治疗重度创伤性脑损伤（TBI）、中风及其他导致ICP升高的病症患者中的疗效。然而，它也承认DC存在潜在并发症，如感染和出血。详细探讨了围绕DC的伦理考量，尤其是针对无法给予同意的患者的具有挑战性的决策过程。特别关注了DC在儿科患者中的应用情况，因为发育中的大脑对压力变化尤为敏感。
