The Efficacy Of The Decompressive Craniectomy

• The accumulation of blood within the cranium, due either to head trauma or flaws in the cerebral vasculature

The sudden movement of brain inside the skull causes the brain to swell. This sudden movement of the brain causes the brain cells to stretch and tear, damaging the cells and creating chemical changes within the brain. It may not be obvious to parents, coaches, trainers and

Different types of intracranial hemorrhages can occur due to injuries to the skull, either directly or indirectly. Epidural hematomas occur when a direct blow to the skull causes injury to the dural arteries or veins that lead to bleeding that accumulates between the dura matter and the skull. If the dural artery is injured, rapid deterioration of the patient neurologic status can occur. As the size of the epidural hematoma increases, the surrounding brain tissues is damaged due to the compression from the pressure of the blood accumulation. The patient may experience a dilated pupil on the side of the injury due to compression of the third cranial nerve. The patient may also complain of a severe headache, visual disturbances and weakness on the opposite side of the injury. If bleeding continues and increases the intracranial pressure, leading to brain shift or herniation of the brain stem which is irreversible and leads to hypertension, bradycardia and respiratory arrest. This trio of symptoms is called the Cushing’s Triad. Epidural hematomas can continue

cranial pressure. This procedure dates back to as early as 7000 BCE. It was used in an

The initial computed tomography (CT) scan of her head revealed multifocal, punctuate brain hemorrhages, consistent with a diffuse axonal injury (DAI). (Figure 1) CT scans of the cervical spine, chest, abdomen, and pelvis revealed bilateral spinous process fractures of C7, T1, and T2, a mid sternal body fracture, bilateral pulmonary contusions, and a distal right clavicle fracture. She also sustained a cardiac contusion associated post-injury arrhythmias, which were treated conservatively. An external ventricular drainage device was placed by neurosurgery to help monitor and manage her intracranial pressure and maintain her cerebral perfusion pressure within acceptable limits.

Over the years, brain surgery has evolved substantially. Looking into multiple types of surgery, surgery is able to be quite unusual. Humans will cut into each other a lot of times in order to get rid of deadly disease and even just to remove excess body fat. The reality that we do not marvel about these on a daily basis shows how advanced surgery has grown over the years. Surgery is a safer and more reliable tool including a necessary component of health care. Previously, the surgeries themselves were brutal from lack of understandings toward anesthesia and none of the tools accessible today with operations forced and traumatic. With the present tools through surgery, brain surgery has changed greatly. This article chosen was aligning with

Traumatic Brain Injury isn’t a true leading cause of death but also represents a financial and personal burden, on the individual and the family. The injury affects all 3 parts within the intracranial space, also includes brain bulk, Cerebrospinal Fluid (CSF), and brain blood volume. Brain bulk increases after water influx to brain tissue or inflammatory response. CSF dynamics can be changed because of communicating hydrocephalus. Brain blood volume within the arterial and venous systems may cause a secondary injury. Also, it says, Intracranial pressure monitoring possibly will be effectively done by the means of an intraventricular catheter, enabling Cerebrospinal Fluid drainage and providing excellent Intercranial Pressure waveforms, facilitating ICP pulse-wave assessment of intracranial compliance.

Nonetheless, prior to an intricate look at the impact on specific brain structures, it is important to understand a TBI, the levels of severity and the immediate implications on a neurological level. The most typical TBI is that of a closed head injury in which no penetration of the skull or brain occurs (Roberts, 2009). Still, impact to the head results in the skull usually hitting a surface as a result of incidents such as falls, accident, sports, assault or abuse (Roberts, 2009). Once a TBI has occurred, a classification of the injuries severity is assessed based on the immediate presentation of symptoms (Roberts, 2009). Mild, moderate and severe classifications are determined based on the presentation (or lack their of) of symptoms such as consciousness and functioning of mental and or sensory process (Roberts, 2009). At the level of the neuron, TBI can cause critical problems. In cases where brain tissue stretches or is sheared, the axon of a neuron becomes weakened due to the stretching, which can result in the

Frequently, it’s difficult to maintain a certain procedure which benefits both the patient and physician. The growth of The Prefrontal Lobotomy was sought out to assist patients with issues regarding mental illnesses, and conditions of psychological disorders. The Prefrontal Lobotomy is said to be successful, but there have been certain times where the procedure has caused death upon a patient. It’s a controversial procedure that has been done widely since it’s prime era. It was widely performed for decades to treat Schizophrenia, Manic Depression and Bipolar Disorder. (Lobotomy: Definition, Procedure, & History; Lewis, 2014)

Traumatic brain injury (TBI) occurs when there is a damage in the brain a result of physical trauma. TBI may be caused by a penetrating (open) head injury, in which an object pierces the skull and enters the brain tissue, or a closed head injury, in which the skull is not breached, and frequently results in the major long-term disability of individuals surviving head injuries.(7) Cranial firearm wounds often result in severe injury to the brain and related central nervous system (CNS) structures.(17). Although penetrating head trauma is less prevalent than closed head trauma, PBI carries a worse prognosis with high morbidity and mortality rates. Understanding of the mechanisms of injury and aggressive medical management with rapid surgical intervention may lead to improved outcomes.(8)

Increased Intracranial Pressure is the skull and the brain tissue. Some of the causes are severe head injuries and brain bleeds Increased Intracranial Pressure."). Some of the symptoms are lethargy, vomiting, and seizures. It is caused when the brain is pressing against

Following a blow to the head the cerebrum goes back and forth in a gliding motion around the upper brainstem. The brainstem along with the cerebellum is firmly fixed in place by the cerebellar tentorium while the cerebral falx prevents any side to side motion. Because of DAI, axons are stretched out as the brain moves and the deformation causes changes in the axonal cytoskeleton, which causes the axoplasmic flow to arrest creating axonal swellings. After this event, it is likely the axons rupture. The different densities of different areas of the human brain are important to take into account. The grey matter is more dense than the white matter; therefore, the white matter travels more rapidly. This explains why diffuse axonal injury lesions are

Colton et al. (2014) research looked at 117 clients who experienced increase intracranial pressure as a result of severe traumatic brain injury. Their research looked at client’s respond to pharmacological interventions and these pharmacological interventions include hypertonic saline, mannitol, propofol, fentanyl, and barbiturate. In their research Colton et al., (2014) found “all treatment resulted in significant intracranial pressure changes after 1 hour or 2 hours except for mannitol and barbiturate administration” (Colton at el., 2014). This finding is significant given that mannitol is used as a first line treatment for management of increased intracranial pressure. The chart below demonstrates how each of these pharmacological interventions decreased intracranial pressure and it allows us to compare each pharmacological intervention to each other. (Colton et al., 2014)

In 1890, a German physician named Quicke described a neurological condition in which patients had signs and symptoms of increased intracranial pressure without a brain tumor being present [1]. Between 1927 and 1937, Dr. Dandy, a pioneer of neurosurgery was able to gather the most common signs and symptoms of 22 patients with pseudotumor cerebri [2]. These symptoms included headache, nausea, vomiting, diplopia, dizziness, and loss of vision. It is important to note that the patient seen in our clinic was not experiencing any of the mentioned symptoms except for vision loss. According to Dr. Dandy, the most common ocular signs were bilateral papilledema and some patients had retinal hemorrhages, which indicated long-standing severe intracranial hypertension. In each case intracranial pressure was measured by ventricular or lumbar puncture and measured to be anywhere from 250 to 550 mm of water and in every instance the ventricles were smaller than normal and symmetrical. The treatment for most of these patients was a right sub-temporal decompression. This was done if the signs and symptoms indicated a need for intervention. In most patients there was a complete, spontaneous cure [2]. A more recent prospective study of 50 patients showed the breakdown of the most common symptoms of idiopathic intracranial hypertension [3]:

When the circulation or absorption of this fluid is blocked, or excessive fluid is produced, the volume of fluid in the brain becomes higher than normal. The accumulation of fluid puts pressure on the brain forcing it against the skull and damaging or destroying the tissues.