In the long-awaited RESCUEicp trial, decompressive craniectomy led to a 22% absolute decrease in mortality, a 6% increase in vegetative state, a 19% increase in survival with disability, and similar rates of full recovery.
In 2011, the DECRA trial showed that early decompressive craniectomy for brain swelling after traumatic brain injury (TBI) was not only ineffective but worsened outcomes. Nevertheless, craniectomy remains in use as salvage therapy for patients at imminent risk of fatal brainstem herniation. Investigators now report on the RESCUEicp trial comparing salvage craniectomy versus continued medical management alone.
Between 2004 and 2014, 52 centers in 20 countries enrolled 408 TBI patients between the ages of 10 and 65 years. Key eligibility requirements were an abnormal computed tomographic (CT) scan and persistently elevated intracranial pressure (>25 mm Hg for >1 hour) despite standard medical therapies except for barbiturates. Patients were ra…
Reviewing Author
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)