Neurol. praxi. 2009;10(1):24-27

Evacuation procedures, external ventricular drainage, and decompressive craniectomy as neurosurgical options for management of intracranial hypertension

MUDr. Jan Klener

Neurochirurgické oddělení Nemocnice Na Homolce

Neurosurgical options for the management of intracranial hypertension are based on the concept of primary and secondary brain damage.

A primary insult cannot be affected; therefore, neurosurgical as well as other treatment modalities aim at minimizing secondary

brain damage.

The authors review the neurosurgical treatment modalities of intracranial hypertension dividing them into three groups: 1. evacuation

procedures during which the pathologically increased tissue volume is removed; 2. derivation procedures allowing a decrease in

intracranial pressure by evacuation of cerebrospinal fluid; 3. decompressive craniectomies enabling a decrease in intracranial pressure

by expanding the „intracranial“ space. Each group is briefly characterized in terms of neurosurgical procedures and their techniques.

More attention is paid to a relatively controversial group of decompressive craniectomies.

In conclusion, emphasis is placed on a multidisciplinary approach in the treatment of intracranial hypertension.

Keywords: intracranial hypertension, epidural haematoma, subdural haematoma, intracerebral haematoma, external ventricular drainage, decompressive craniectomy.

Published: March 1, 2009  Show citation