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Decompressive Craniectomy for Diffuse Traumatic Brain Injury: The DECRA Trial 

Decompressive Craniectomy for Diffuse Traumatic Brain Injury: The DECRA Trial
Chapter:
Decompressive Craniectomy for Diffuse Traumatic Brain Injury: The DECRA Trial
Author(s):

Shivani Ghoshal

DOI:
10.1093/med/9780199377527.003.0020
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date: 16 September 2019

This chapter provides a summary of a landmark study in neurocritical care. Is decompressive craniectomy or medical management more effective for obtaining better outcomes in traumatic brain injury patients with increased intracranial pressure? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. For severe TBI patients without mass lesions, decompressive craniectomy for refractory intracranial pressure elevations after first-tier therapy was found to significantly lower pressure and reduce both days of mechanical ventilation and ICU length of stay; however, it possibly led to worse 6-month functional outcomes versus third-tier therapies. The chapter briefly reviews other relevant studies and information, and concludes with a relevant clinical case.

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