Abstract
Introduction
Decompressive Craniectomies (DC) are a controversial treatment for increased intracranial pressure resulting from traumatic head injuries. The technique has been around for approximately 5000 years, but only now are researchers beginning to unlock its true potential. This article aims to summarize history, review current knowledge and identify the implications of pre-hospital emergency care.
Methods
An electronic search was conducted using the databases; Medline (via EBSCOHost), BioMed Central and Cochrane Database of Systematic Reviews.
Results
One hundred and thirty-one articles were identified. Articles excluded from analysis were those unavailable as full text, not available in English and review articles. Twenty articles were included in the analysis.
Conclusion
Decompressive craniectomy is a comparable treatment to alternative techniques. Until recently mortality rates have been misinterpreted and unfairly reported due to the severity of brain injuries patients had already suffered. Timing of decompressive craniectomy is a crucial factor of patient outcome, and it is of popular belief that the best chance of optimal recovery relies on a reduced injury to treatment time. Introducing decompressive craniectomy into the pre-hospital setting may see an increase in favourable outcomes and has the potential to save the health care system millions of dollars in associated costs for patients with traumatic brain injury.