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What Is Decompressive Craniotomy Surgery and Why Is It Done?

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Updated March 09, 2011

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After Brain Surgery

Bandaged After Brain Surgery

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Question: What Is Decompressive Craniotomy Surgery and Why Is It Done?
Answer:

If your loved one has had a traumatic brain injury, one of the recommended treatments may be a decompressive craniotomy or craniectomy. This type of brain surgery is for patients who will die without intervention, and is done to relieve pressure on the brain.

A decompressive craniectomy surgery is a procedure that removes a section of the skull to relieve pressure on the brain. It is an incision first made in the scalp, then through the bone using a special saw, which allows a piece of the skull to be removed.

The brain is unique in the human body because it is surrounded by bone. With other types of injuries, such as a sprained ankle, the injury will swell without causing further damage. Because the brain is encased in bone, swelling can put tremendous pressure on the brain, and can even lead to death.

In order to prevent damage to the delicate tissues of the brain, a section of the skull is removed, which relieves pressure and gives the brain a place to swell without causing more damage. For less severe injuries a ventriculostomy is typically done, which is less invasive than a craniotomy.

It is important to remember that a decompressive craniectomy is done for severe brain injuries and swelling that cannot be controlled by other means including medications or a ventriculostomy. While the procedure can help prevent further damage, the initial injury and the subsequent swelling may still cause damage. Severe swelling may still result in long term deficits or even death, however, the chances of survival are improved by the procedure for most patients.

Craniotomy VS Craniectomy

Sources:

Decompressive Craniectomy For Refractory Intracranial Hypertension After Traumatic Brain Injury. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. Accessed January 2010.http://ccforum.com/content/10/S1/P458

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