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Decompressive Laparotomy for Refractory Intracranial Hypertension After Traumatic Brain Injury.
MedLine Citation:
PMID:  21519956     Owner:  NLM     Status:  Publisher    
BACKGROUND: Intracranial hypertension is a crucial modifiable risk factor for poor outcome after traumatic brain injury (TBI). Limited evidence suggests that decompressive laparotomy may be an effective treatment for refractory ICH in patients who have elevated intra-abdominal pressure. METHODS: Case report. RESULTS: We present a multi-trauma patient who sustained severe TBI in a motor vehicle collision. Intracranial pressure (ICP) was initially medically managed but became refractory to standard therapies. Emergent decompressive laparotomy performed in the surgical intensive care unit for abdominal compartment syndrome concomitantly improved the patient's ICP. CONCLUSIONS: Elevated intra-abdominal pressure can exacerbate intracranial hypertension in patients with TBI. Recognition of this condition and treatment with decompressive laparotomy may be useful in patients with intracranial hypertension refractory to optimal medical therapy.
Jon D Dorfman; Joseph D Burns; Deborah M Green; Christina Defusco; Suresh Agarwal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-26
Journal Detail:
Title:  Neurocritical care     Volume:  -     ISSN:  1556-0961     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Surgery, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA.
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