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Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury.

Publication ,  Journal Article
Dorfman, JD; Burns, JD; Green, DM; DeFusco, C; Agarwal, S
Published in: Neurocrit Care
December 2011

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.

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Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

December 2011

Volume

15

Issue

3

Start / End Page

516 / 518

Location

United States

Related Subject Headings

  • Trauma Centers
  • Tomography, X-Ray Computed
  • Neurology & Neurosurgery
  • Multiple Trauma
  • Mannitol
  • Laparotomy
  • Intracranial Pressure
  • Intracranial Hypertension
  • Intra-Abdominal Hypertension
  • Interdisciplinary Communication
 

Citation

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Dorfman, J. D., Burns, J. D., Green, D. M., DeFusco, C., & Agarwal, S. (2011). Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury. Neurocrit Care, 15(3), 516–518. https://doi.org/10.1007/s12028-011-9549-0
Dorfman, Jon D., Joseph D. Burns, Deborah M. Green, Christina DeFusco, and Suresh Agarwal. “Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury.Neurocrit Care 15, no. 3 (December 2011): 516–18. https://doi.org/10.1007/s12028-011-9549-0.
Dorfman JD, Burns JD, Green DM, DeFusco C, Agarwal S. Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury. Neurocrit Care. 2011 Dec;15(3):516–8.
Dorfman, Jon D., et al. “Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury.Neurocrit Care, vol. 15, no. 3, Dec. 2011, pp. 516–18. Pubmed, doi:10.1007/s12028-011-9549-0.
Dorfman JD, Burns JD, Green DM, DeFusco C, Agarwal S. Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury. Neurocrit Care. 2011 Dec;15(3):516–518.
Journal cover image

Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

December 2011

Volume

15

Issue

3

Start / End Page

516 / 518

Location

United States

Related Subject Headings

  • Trauma Centers
  • Tomography, X-Ray Computed
  • Neurology & Neurosurgery
  • Multiple Trauma
  • Mannitol
  • Laparotomy
  • Intracranial Pressure
  • Intracranial Hypertension
  • Intra-Abdominal Hypertension
  • Interdisciplinary Communication