There has been a recent important update to the Brain Trauma Foundation guidelines regarding decompressive craniectomy for intractable intracranial hypertension, published in Neurosurgery. The latest iteration of the BTF guidelines from 2016 was released prior to the publication of the RESCUEicp study, as well as the 12 month outcome data from the DECRA trial. With… Continue reading BTF guidelines – Decompressive Craniectomy Update
After completing recruitment of some 408 TBI patients in 2014, the RESCUEicp group finally published the results from this eagerly awaited trial. The article by Hutchinson et al, titled Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension, was published on September 7th in the New England Journal of Medicine. So let´s go straight to the core: The study… Continue reading RESCUEicp Trial Results Finally Out: Craniectomy in TBI Lowers Mortality, But Survivors Suffer Worse Neurological Outcomes
An Evidence-Based Consensus Statement from the Neurocritical Care Society. Read more here. Best regards, Riikka Takala.
The excellent reviewers at The Bottom Line are taking a thorough look at the STITCH (Trauma) trial of 2015. The STITCH (Trauma) trial (Early Surgery versus Initial Conservative Treatment in Patients with Traumatic Intracerebral Hemorrhage) recruited 170 patients into a multicenter RCT to determine whether early surgery (within 12 hours) for traumatic intracerebral haemorrhage would confer a mortality benefit… Continue reading The Bottom Line – The STITCH Trial
The full statement is available here: The Insertion and Management of External Ventricular Drains: An Evidence-Based Consensus Statement – A Statement for Healthcare Professionals from the Neurocritical Care Society. Published in Neurocritical Care 2016.
Intermittent versus continuous cerebrospinal fluid drainage management in adult severe traumatic brain injury: assessment of intracranial pressure burden. This small cohort study (n=62) from 2014 by Nwachuku EL suggests that continuous drainage is associated with better ICP-control. Read the abstract in Neurocritical Care.
Important trial dealing with the contentious issue of decompressive craniectomy for diffuse traumatic brain injury. Cooper et al. New England Journal of Medicine 2011. “In adults with severe diffuse traumatic brain injury and refractory intracranial hypertension, early bifrontotemporoparietal decompressive craniectomy decreased intracranial pressure and the length of stay in the ICU but was associated with… Continue reading DECRA trial – Decompressive Craniectomy in Diffuse Traumatic Brain Injury