decompressive hemicraniectomy
Surgical removal of skull bone to allow brain swelling and reduce intracranial pressure.
Full Definition
Decompressive hemicraniectomy is a neurosurgical procedure involving the removal of a large portion of skull bone (typically greater than 12cm diameter) to allow the brain to swell outward rather than inward, thereby reducing intracranial pressure. This life-saving procedure is typically reserved for cases of malignant cerebral edema that is refractory to medical management, such as malignant middle cerebral artery infarction, traumatic brain injury with mass effect, or other causes of severe brain swelling. The procedure involves removing bone from the frontal, parietal, and temporal regions, and opening the dura mater. While often life-saving, the procedure carries significant risks and potential for long-term disability, requiring careful patient selection and family counseling.
Usage
Usage note: Hyphenate compound term; distinguish from other cranial procedures by specifying 'decompressive'.
In Context
- "Emergency decompressive hemicraniectomy was performed for malignant MCA syndrome with impending herniation." — operative report
- "The patient underwent decompressive hemicraniectomy followed by cranioplasty reconstruction three months later." — discharge summary