Decompressive Craniectomy

A stroke is damage to the brain that occurs when blood flow to an area of the brain is cut off. This deprives brain cells of oxygen and they begin to die. How a person is affected by their stroke depends on where the stroke occurs in the brain and how much the brain is damaged. At Athens Brain & Spine, one of the treatments we use to help stroke victims is a decompressive craniectomy.

In a decompressive craniectomy, part of the skull is removed to allow a swelling brain room to expand without being squeezed. It can improve recovery from a stroke by decreasing the level of intracranial pressure, an extremely debilitating and potentially fatal side effect of strokes. When used to manage major strokes, a decompressive craniectomy within 48 hours of the malignant stroke may result in improved survival and functional outcome.

It is important to remember that a decompressive craniectomy is done for severe brain injuries and swelling that cannot be controlled by other means including medications or a ventriculostomy. While the procedure can help prevent further damage, the initial injury and the subsequent swelling may still cause damage. Severe swelling may still result in long term deficits or even death, however, the chances of survival are improved by the procedure for most patients.

After a craniectomy, the risk of brain injury is increased, particularly after you, the patient, heal and become mobile again. Therefore, special measures must be taken to protect the brain, such as a helmet or a temporary implant in the skull. Once you have healed sufficiently, the opening in the skull is usually closed with a cranioplasty. If possible, we will attempt to preserve the original skull fragment after the craniectomy in anticipation of the cranioplasty.