Open AccessCerebral microdialysis and PtiO2 to decide unilateral decompressive craniectomy after brain gunshot
Author(s) -
Henry Boret,
E. Carre,
Prunet Bertrand,
Erwan D’Aranda
Publication year - 2012
Publication title -
journal of emergencies, trauma and shock
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.313
H-Index - 29
eISSN - 0974-519X
pISSN - 0974-2700
DOI - 10.4103/0974-2700.93101
Subject(s) - decompressive craniectomy , medicine , intracranial pressure , microdialysis , traumatic brain injury , anesthesia , brain tissue , surgery , central nervous system , psychiatry
Decompressive craniectomy (DC) following brain injury can induce complications (hemorrhage, infection, and hygroma). It is then considered as a last-tier therapy, and can be deleteriously delayed. Focal neuromonitoring (microdialysis and PtiO2) can help clinicians to decide bedside to perform DC in case of intracranial pressure (ICP) around 20 to 25 mmHg despite maximal medical treatment. This was the case of a hunter, brain injured by gunshot. DC was performed at day 6, because of unstable ICP, ischemic trend of PtiO2, and decreased cerebral glucose but normal lactate/pyruvate ratio. His evolution was good despite left hemiplegia due to initial injury.