Abstract
The monograph summarizes the current knowledge on decompressive craniectomy, a neurosurgical procedure that, despite undergoing a renaissance in recent years, is nevertheless still regarded as controversial operation. Decompressive craniectomy is performed in patients with uncontrollable intracranial hypertension caused by brain oedema, which accompanies various brain pathologies.
The publication is divided into nine basic chapters the first chapter presents a history of decompressive craniectomy and the basic principles behind the operation. There then follows a part devoted to intracranial pressure, cerebral perfusion pressure and cerebral blood flow as well as the associated problem of brain death.
A separate chapter focuses on the subject of neuromonitoring, which is an essential part of the contemporary indication process for decompressive craniectomy. The most extensive chapter covers the current evidence of the effectiveness of decompression for a variety of pathological conditions described in all key studies on the subject.
The technical aspects of the operation are described in detail and presented are both currently and formerly used techniques. There are sections on post-operative care, a detailed description of the potential complications of decompression and further cranioplasty.
Illustrations, tables and images accompany the text. Some figure legends are written as short case reports, which describe the topic in terms of concrete approaches in clinical practise.
At the end of the publication, there is a discussion on the potential reasons for the lack of evidence of effectiveness of the operation, particularly for patients with traumatic brain injury. Finally, numerous contributions to the field by the Pilsner neurosurgical department are presented.
The book should provide a comprehensive source of information, not only for neurosurgeons, but also for neurologists, intensivists, and radiologists.