2018 AANS Annual Scientific Meeting-Threshold of Postoperative ICP Necessary for Better Than Vegetative Outcome After De-compressive Craniectomy for Severe Traumatic Brain Injuries

Threshold of Postoperative ICP Necessary for Better Than Vegetative Outcome After De-compressive Craniectomy for Severe Traumatic Brain Injuries

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Video Summary

Dr. El-Fikhi from Egypt discussed the threshold of postoperative intracranial pressure (ICP) necessary for a better outcome after decompressive craniectomy. He emphasized the importance of reducing post-trauma disability, especially in a country like Egypt where there is a high incidence of pedestrian accidents. Dr. El-Fikhi mentioned that there is no specific drug treatment for severe traumatic brain injury (TBI) and highlighted the importance of using multimodal monitoring. He stated that refractory ICP is essential for brain herniation, but it is not the only factor, and individualized treatment based on physiological parameters is necessary. He referred to various guidelines and studies, including the DECRA study and the BESTRIP study, which showed a shift towards a better outcome in patients whose ICP was monitored. Dr. El-Fikhi presented data from his own study, highlighting the importance of maintaining a postoperative ICP below a certain level for at least one week after decompressive craniotomy. He discussed the management of patients with persistently high ICP and mentioned using barbiturate coma, hypertonic saline, and other means to lower ICP. Overall, Dr. El-Fikhi's research suggests that maintaining a specific threshold of postoperative ICP can lead to improved outcomes for patients after decompressive craniectomy.

Asset Caption

Mohamed E. El-Fiki, MD (Egypt, Arab Rep.)

Keywords

postoperative intracranial pressure

decompressive craniectomy

traumatic brain injury

multimodal monitoring