====== Decompressive craniectomy indications ======

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[[Decompressive craniectomy]] (DC) is a widely used for refractory [[intracranial hypertension treatment]]. 

Indications (controversial) include:

1. [[Malignant middle cerebral artery territory infarction]] primarily for the nondominant hemisphere. Use on the dominant side is more controversial

2. Traumatic [[intracranial hypertension]].

a) As an adjunct for persistent intracranial hypertension when other ICP control measures fail 
((Bullock MR, Chesnut RM, Ghajar J, et al. Surgical management of traumatic parenchymal lesions. Neurosurgery. 2006; 58:S25–S46)).

b) early in the management: maybe considered for patients undergoing emergent surgery (for fracture, EDH, SDH...)
((Holland M, Nakaji P. Craniectomy: Surgical indica- tions and technique. Operative Techniques in Neurosurgery. 2004; 7:10–15))

3. uncontrollable [[brain swelling]] during [[craniotomy]] 

4. reported in children with refractory nontraumatic intracranial hypertension
((Aghakhani Nozar, Durand Philippe, Chevret Laurent, et al. Decompressive craniectomy in children with nontraumatic refractory high intracranial pressure. Journal of Neurosurgery: Pediatrics. 2009; 3:66–69))

(e.g. infection, infarction, Reye’s syndrome...).
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Raised intracranial pressure is very often debilitating or fatal because it causes compression of the brain and restricts cerebral blood flow. The aim of decompressive craniectomy is to reduce this pressure. 



===== Decompressive craniectomy for traumatic brain injury =====

see [[Decompressive craniectomy for severe traumatic brain injury indications]].

===== Decompressive craniectomy for ischemic stroke =====

see [[Decompressive craniectomy for ischemic stroke indications]].

===== Decompressive craniectomy for intracerebral hemorrhage =====

[[Decompressive craniectomy for intracerebral hemorrhage indications]].

===== Suboccipital decompressive craniectomy for cerebellar infarction =====
[[Suboccipital decompressive craniectomy for cerebellar infarction]].




===== Decompressive craniectomy for intracranial hypertension treatment =====

[[Decompressive craniectomy for intracranial hypertension treatment]].

===== Decompressive craniectomy for malignant middle cerebral artery territory infarction =====
[[Decompressive craniectomy for malignant middle cerebral artery territory infarction]]

===== Decompressive craniectomy for cerebral venous sinus thrombosis =====
[[Decompressive craniectomy for cerebral venous sinus thrombosis]].