TWO CASES OF INTRACRANIAL PRESSURE MANAGEMENT BY DECOMPRESSIVE CRANIECTOMY AND VENTRICULAR DRAINAGE : EVALUATION OF USEFULNESS IN SEVERE TRAUMATIC HEAD INJURY

Abstract

　　A 34-year-old male and 21-year-old male had consciousness below GCS score 8 when they arrived at the hospital. They had cerebral herniation due to cerebral contusion and worsening cerebral edema. We performed decompressive craniectomy and ventricular drainage. Although the edema was severe, craniectomy was minimized by ventricular drainage, intracranial pressure was controlled, and there were no complications related to the surgical procedure. Ventricular drainage in combination with decompressive craniectomy can be performed without significantly affecting the overall operative time and may minimize the extent of craniectomy. Even if cerebral edema worsens postoperatively, drainage of cerebrospinal fluid can significantly reduce intracranial pressure and improve outcome.