Bifrontal Decompressive Craniotomy in a 6-Month-Old Infant with Posttraumatic Refractory Intracranial Hypertension

Vol. 41, No. 3, 2005

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Case Report

Bifrontal Decompressive Craniotomy in a 6-Month-Old Infant with Posttraumatic Refractory Intracranial Hypertension
Sherif El-Watidy

Neurosurgery Division, KKUH, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Address of Corresponding Author

Pediatric Neurosurgery 2005;41:151-154 (DOI: 10.1159/000085874)

Key Words

Bifrontal decompressive craniotomy
Head injury
Refractory intracranial hypertension

Abstract

Objective: To document the outcome of bifrontal decompressive craniotomy (BDC) in an infant who developed refractory intracranial hypertension (IH) and massive brain infarction following severe head injury. Clinical Presentation: A 6-month-old girl sustained a severe closed head injury in a car accident. Her Glasgow coma score dropped from 10 to 6/15 within 6 h after admission, and her pupils became dilated and fixed. CT brain scans showed severe brain swelling and extensive infarction in both cerebral hemispheres with no grey-white mater differentiation. She developed a state of refractory IH despite maximal medical treatment. Intervention: She hadBDC and duraplasty carried out 8 h after admission. She made a quick recovery to Glasgow outcome score 3, and her total hospital stay was 10 weeks. Conclusion: BDC can be a life-saving procedure for infants with refractory IH and massive brain infarction.

Author Contacts

Sherif El-Watidy, Assistant Professor
Neurosurgery Division, KKUH
College of Medicine, King Saud University
PO Box 7805 (37), Riyadh 11472 (Saudi Arabia)
Tel. +966 1 4671575, Fax +966 1 4679493, E-Mail smfwat@yahoo.com

Article Information

Received: July 13, 2004
Accepted after revision: December 29, 2004
Number of Print Pages : 4
Number of Figures : 5, Number of Tables : 0, Number of References : 19

Medline Abstract (ID 15995334)

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