TY - JOUR
T1 - Consensus statement from the International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury
T2 - Consensus statement
AU - Hutchinson, Peter J.
AU - Kolias, Angelos G.
AU - Tajsic, Tamara
AU - Adeleye, Amos
AU - Aklilu, Abenezer Tirsit
AU - Apriawan, Tedy
AU - Bajamal, Abdul Hafid
AU - Barthélemy, Ernest J.
AU - Devi, B. Indira
AU - Bhat, Dhananjaya
AU - Bulters, Diederik
AU - Chesnut, Randall
AU - Citerio, Giuseppe
AU - Cooper, D. Jamie
AU - Czosnyka, Marek
AU - Edem, Idara
AU - El-Ghandour, Nasser M.F.
AU - Figaji, Anthony
AU - Fountas, Kostas N.
AU - Gallagher, Clare
AU - Hawryluk, Gregory W.J.
AU - Iaccarino, Corrado
AU - Joseph, Mathew
AU - Khan, Tariq
AU - Laeke, Tsegazeab
AU - Levchenko, Oleg
AU - Liu, Baiyun
AU - Liu, Weiming
AU - Maas, Andrew
AU - Manley, Geoffrey T.
AU - Manson, Paul
AU - Mazzeo, Anna T.
AU - Menon, David K.
AU - Michael, Daniel B.
AU - Muehlschlegel, Susanne
AU - Okonkwo, David O.
AU - Park, Kee B.
AU - Rosenfeld, Jeffrey V.
AU - Rosseau, Gail
AU - Rubiano, Andres M.
AU - Shabani, Hamisi K.
AU - Stocchetti, Nino
AU - Timmons, Shelly D.
AU - Timofeev, Ivan
AU - Uff, Chris
AU - Ullman, Jamie S.
AU - Valadka, Alex
AU - Waran, Vicknes
AU - Wells, Adam
AU - Wilson, Mark H.
AU - Servadei, Franco
N1 - Funding Information:
Acknowledgements Peter Hutchinson is supported by a Research Professorship from the National Institute for Health Research (NIHR), the NIHR Cambridge Biomedical Research Centre, the NIHR Global Health Research Group on Neurotrauma, a European Union Seventh Framework Program grant (CENTER-TBI; grant no. 602150), and the Royal College of Surgeons of England. Angelos Kolias is supported by a Clinical Lectureship, School of Clinical Medicine, University of Cambridge. We would also like to thank Natalia Budohoska, Max Pitches, and Carole Turner from the Division of Neurosurgery, University of Cambridge for their assistance with organising the meeting.
Funding Information:
Peter Hutchinson is supported by a Research Professorship from the National Institute for Health Research (NIHR), the NIHR Cambridge Biomedical Research Centre, the NIHR Global Health Research Group on Neurotrauma, a European Union Seventh Framework Program grant (CENTER-TBI; grant no. 602150), and the Royal College of Surgeons of England. Angelos Kolias is supported by a Clinical Lectureship, School of Clinical Medicine, University of Cambridge. We would also like to thank Natalia Budohoska, Max Pitches, and Carole Turner from the Division of Neurosurgery, University of Cambridge for their assistance with organising the meeting.
Publisher Copyright:
© 2019, The Author(s).
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background: Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach. Methods: The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries. Results: The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval. Conclusions: In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.
AB - Background: Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach. Methods: The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries. Results: The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval. Conclusions: In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.
KW - Cranioplasty
KW - Decompression
KW - Neurosurgery
KW - Neurotrauma
UR - http://www.scopus.com/inward/record.url?scp=85067382108&partnerID=8YFLogxK
U2 - 10.1007/s00701-019-03936-y
DO - 10.1007/s00701-019-03936-y
M3 - Review article
C2 - 31134383
AN - SCOPUS:85067382108
SN - 0001-6268
VL - 161
SP - 1261
EP - 1274
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 7
ER -