Turkish Neurosurgery
Clinical Study of Decompressive Craniectomy in Children
Burcu Goker1, Dogan Gucluhan Guclu2, Ilyas Dolas3, Utku Ozgen3, Muhittin Emre Altunrende4, Ahmet Tolgay Akinci5, Fahir Sencan6, Aydin Aydoseli3, Halil Can7, Altay Sencer3
1Istinye University School of Medicine, Liv Hospital-Ulus, Department of Neurosurgery, İstanbul,
2University of Health Sciences, Bakırköy Sadi Konuk Research and Training Hospital, , Department of Neurosurgery, İstanbul,
3Istanbul School of Medicine, Istanbul University, Department of Neurosurgery, İstanbul,
4University of Health Sciences, Gaziosmanpaşa Taksim Research and Training Hospital, , Department of Neurosurgery, İstanbul,
5Trakya University School of Medicine, Department of Neurosurgery, Edirne,
6Istinye University School of Medicine, Liv Hospital-Bahçeşehir, Department of Neurosurgery, İstanbul,
7Biruni University School of Medicine, Department of Neurosurgery, İstanbul,
8Medicine Hospital, Department of Neurosurgery, İstanbul,
DOI: 10.5137/1019-5149.JTN.27576-19.3

Aim:The incidence of head injury has increased among pediatric patients, and traumatic brain injury is a leading cause of death in children. Decompressive craniectomy (DC) is a surgical intervention performed to increase cranial volume and is used for the treatment of intracranial hypertension. Moreover, such procedure has gained wide acceptance. However, its effect on morbidity and mortality particularly in children must be validated. This study aimed to evaluate the clinical characteristics of children who recently underwent DC due to elevated intracranial pressure (ICP) correlated to head trauma or other causes, such as ischemic insult.Material and Methods:Twelve patients aged ≤ 17 who were treated with DC due to elevated ICP between 2013 and 2018 were included into the study. Their clinical status, radiological characteristics, type and timing of surgery and outcome was recorded.Results:There were three female and nine male patients with mean age of 10. Initial neurological examination revealed that the average Glasgow Coma Scale (GCS) was 6 (3-12). All patients showed signs of diffuse cerebral edema and had subdural hematoma of various sizes alongside other intracranial pathologies. Only one patient required bilateral frontal craniectomy. In postoperative period, three patients died, and three patients were severely disabled.Conclusion:With the increasing use and success of DC in adults, this procedure can also be effective in children. Considering brain differences in children, large and well-structured clinical trials must be conducted to prevent complications and to identify the best technique, timing, and benefits of DC for children.

Corresponding author : Burcu Goker