Decompressive Craniectomy Versus Cisternostomy in Traumatic Intracranial Hypertension. Systematic Review

Abstract

To compare the usefulness of decompressive craniectomy versus cisternostomy in the surgical management of Traumatic Intracranial Hypertension was the objective of the present bibliographic review. A search was carried out for articles in journals from the databases: PubMed, Scielo and EBSCO. The key words used were: intracranial hypertension, severe craniocerebral trauma, decompressive craniectomy and cisternostomy. Searches were conducted with these terms in English and Spanish. Articles with the full text were consulted, published mainly between 2015 and 2023 in Spanish or English, although in multicenter and multinational studies with high global impact on the topic, the year of publication was not taken into account, given the importance of its inclusion in the present review. Articles that reflected controversies about Decompressive Craniectomy and Cisternostomy as a measure in ICH refractory to medical treatment were selected with priority. Decompressive craniectomy and Cisternostomy are surgical methods that have been shown to reduce intracranial pressure and mortality in patients with traumatic intracranial hypertension refractory to medical therapy, although decompressive craniectomy presents a higher and more reliable level of evidence than cisternostomy, the new mechanisms for reducing intracranial pressure in the latter procedure seem promising in the near future.