Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Decompressive craniectomy in pediatric patients. | Available online http content 7 6 409 Commentary Decompressive craniectomy in pediatric patients Richard S Polin1 Michael Ayad2 and John A Jane3 Assistant Professor Department of Neurological Surgery George Washington University Hospital Washington District of Columbia USA 2Resident Department of Neurological Surgery George Washington University Hospital Washington District of Columbia USA 3Professor and Chairman Department of Neurosurgery University of Virginia Health Sciences Center Charlottesville Virginia USA Correspondence Richard S Polin rpolin@ Published online 10 September 2003 Critical Care 2003 7 409-410 DOI cc2370 This article is online at http content 7 6 409 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract More frequently than adults pediatric victims of severe traumatic brain injury experience diffuse severe cerebral edema without mass lesions. These patients require methods to reduce intracranial pressure quickly and reliably. Surgical decompression provides rapid relief of increased intracranial pressure and is an alternative to maximal medical therapy for these individuals. Based on previous trials most of which are anecdotal but now include attempts at case controlled and cohort matched investigations Ruf and colleagues describe a series of six pediatric patients treated with a prospectively implemented protocol of decompressive craniectomy for severe traumatic brain injury. The heterogeneous approaches presented which include hemicraniectomy bifrontal craniectomy and suboccipital craniectomy undermine the applicability of the results. However this report coupled with similar papers does highlight the need for a true controlled trial of this modality to examine whether craniectomy can emerge as more than a second line option for the management of increased intracranial pressure. Keywords craniectomy intracranial pressure monitoring intracranial pressure traumatic brain injury .
