Citation

Janatpour ZC, Szuflita NS, Spinelli J, Coughlin DJ, Rosenfeld JV, Bell RS. Mil. Med. 2019; ePub(ePub): ePub.

Affiliation

Division of Neurosurgery, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center 8901 Rockville Pike, Bethesda, MD.

Copyright

(Copyright © 2019, Association of Military Surgeons of the United States)

DOI

10.1093/milmed/usz008

PMID

30793187

Abstract

Traumatic brain injury has been called the "signature injury" of the wars in Iraq and Afghanistan, and the management of severe and penetrating brain injury has evolved considerably based on the experiences of military neurosurgeons. Current guidelines recommend that decompressive hemicraniectomy be performed with large, frontotemporoparietal bone flaps, but practice patterns vary markedly. The following case is illustrative of potential clinical courses, complications, and efforts to salvage inadequately-sized decompressive craniectomies performed for combat-related severe and penetrating brain injury. The authors follow this with a review of the current literature pertaining to decompressive craniectomy, and finally provide their recommendations for some of the technical nuances of performing decompressive hemicraniectomy after severe or penetrating brain injury.

© Association of Military Surgeons of the United States 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Language: en

Keywords

TBI; combat; decompressive craniectomy; military; penetrating brain injury; wartime