Indications for Surgical Decompression

EB Edson Bor-Seng-Shu
Md Marcelo de-Lima-Oliveira
RN Ricardo Carvalho Nogueira
KA Kelson James Almeida
EP Eric Homero Albuquerque Paschoal
FJ Fernando Mendes Paschoal, Jr.
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DC was performed in patients with neurological deterioration and CT scans disclosing predominantly unilateral diffuse brain swelling associated with mass effect, a midline shift and/or obliteration of peri-mesencephalic cisterns. Neurological worsening was defined as a decrease in GCS score and/or unilaterally or bilaterally unresponsive and dilated pupils. Patients with persisting GCS score of 3 and/or bilaterally fixed and dilated pupils were not operated on. The surgical technique consisted of large hemicraniectomy with dural opening over the most swollen cerebral hemisphere.

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