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Surgical Treatment of Raised Intracranial Pressure 

Surgical Treatment of Raised Intracranial Pressure
Chapter:
Surgical Treatment of Raised Intracranial Pressure
Author(s):

Mohamed A. Zaazoue

and Richard B. Rodgers

DOI:
10.1093/med/9780190936259.003.0002
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date: 02 July 2022

Traumatic brain injury (TBI) is a common problem encountered in the emergency department, and neurosurgeons are typically involved early in the management. Prompt physical examination and head CT are crucial to assess TBI patients and determine their management plan. Intracranial pressure (ICP) monitoring is indicated for patients with altered mental status and abnormal imaging. ICP management is a tiered approach, with early tiers involving nonsurgical, and medical interventions. For patients with uncontrolled elevation of ICP, there are three possible surgical interventions: external ventricular drain placement, evacuation of mass lesion, and/or decompressive craniectomy (unilateral or bilateral). Finally, when patients who underwent craniectomy recover from the acute phase of TBI, cranioplasty is performed for cosmetic purposes and potential neurological benefit.

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