Four-quadrant osteoplastic decompressive craniotomy: A novel technique for decompressive craniectomy avoiding revision cranioplasty after surgery

摘要

There are several surgical procedures to reduce elevated intracranial pressure (ICP) in patients with traumatic brain injury. Decompressive craniectomy (DC) with duroplasty is the most widely accepted surgical procedure. [1] This procedure may be associated with morbidity in the immediate postoperative period as the large bone defect may pose a risk of potential injuries to the underlying brain. [2] Cranioplasty may also be associated with complications that follow any brain surgery. We designed a surgical procedure, the four-quadrant osteoplastic decompressive craniotomy (FoQOsD), which mimics a communited fracture and may not cause a significant resistance to the expanding brain thus reducing elevated ICP. This technique does not require a second surgery to replace the bone flap.