INTRODUCTION: The purpose of this study was to assess the role of decompressive craniectomy (DC) inpatients with post-traumatic intractable @entity428 ( @entity428 ) in the absence of an evacuable @entity1779 . METHODS: Retrospective study at LAC+USC Medical Centre including @entity1 who underwent DC for post-traumatic malignant @entity4 or @entity428 without space occupying @entity548 , during the period 01/2004 to 12/2008. The analysis included the effect of DC on intracranial pressure (ICP) and timing of DC on functional outcomes and survival. RESULTS: Of 106 @entity1 who underwent DC, 43 @entity1 met inclusion criteria. Of those, 34 were operated within the first 24 h from admission. DC decreased the ICP significantly from 37.8    12.1 mmHg to 12.7    8.2 mmHg in survivors and from 52.8    13.0 to 32.0    17.3 mmHg in non-survivors. Overall 25.6%died (11 of 43), and 32.5% (14 of 43) remained in vegetative state or were severely disabled. Favourable outcome (Glasgow Outcome Scale 4 and 5) was observed in 41.9% (18 of 43). No tendency towards either increased or decreased incidence in favourable outcome was found relative to the time from admission to DC.Six of the 18 @entity1 (33.3%) with favourable outcome were operated on within the first 6 h. CONCLUSIONS: DC lowers ICP and raises CPP to high normal levels in survivors compared to non-survivors.The timing of DC showed no clear trend, for either good neurological outcome or @entity204 . Overall, the survival rate of 74.4% is promising and 41.9% had favourable neurological outcome.

Decompressive craniectomy: surgical control of traumatic XXXX may improve outcome.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['haemorrhage'] @entity428 :: ('MESH:D019586', 'Disease') :: ['intracranial hypertension', 'ICH'] @entity4 :: ('MESH:D004487', 'Disease') :: ['brain swelling'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1779 :: ('MESH:D002543', 'Disease') :: ['intracerebral haemorrhage']
@entity428 :: (MESH:D019586,Disease) :: ['intracranial hypertension']
