| Peer-Reviewed

Decompresive Craniectomy in Infants at Fann University Hospital in Dakar

Received: 11 February 2021     Accepted: 3 March 2021     Published: 12 March 2021
Views:       Downloads:
Abstract

Introduction: Decompressive craniectomy is a neurosurgical technique indicated as a last resort in the management of intracranial hypertension refractory to medical treatment. Carried out in infants, it represents an additional challenge due to the morbidity and mortality with which it is associated. The objective of our study was to report the experience of the neurosurgery department of Fann University Hospital in Dakar. Patients and Methods: It's a retrospective study on 4 infants who have undergone a decompressive craniectomy at Fann University Hospital in Dakar over a period of 10 years, from January 1, 2010 to December 31, 2020. Results: Four patients under 2 years of age underwent decompressive craniectomy out of a total of 26 patients over the study period. The mean age at diagnosis was 10 months with extreme (60 days to 24 month). The average consultation time was 3 days with extremes (1 to 8 days). Two infants had had severe head trauma. Only one infant showed significant clinical improvement postoperatively; the other three died within 1 to 6 days of surgery. These deaths were linked to acute bleeding in 75% of cases. The mean survival time was 2 days with extremes ranging from 1 to 4 days. Conclusion: Decompresive craniectomy remains the challenge in infants due to the risk of bleeding and hemodynamic instability. Given the low number of publications, we encourage other authors to share their. In our study, three patients died at the end of the operation from bleeding complications. Among these deaths a patient had a coagulopathy which also poses another challenge to the management of these patients.

Published in International Journal of Neurosurgery (Volume 5, Issue 1)
DOI 10.11648/j.ijn.20210501.13
Page(s) 8-12
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Decompresive Craniectomy, Infant, Subdural Hematoma, Intracranial Hypertension

References
[1] Yokota H, Sugimoto T, Nishiguchi M, Hashimoto H. Greenstick fracture-hinge decompressive craniotomy in infants: illustrative case and literature review of techniques for decompressive craniotomy without bone removal. Childs Nerv Syst. 2019 Sep; 35 (9): 1491-1497. doi: 10.1007/s00381-019-04177-1. Epub 2019 May 8. PMID: 31069483.
[2] Adamo MA, Drazin D, Waldman JB. Decompressive craniectomy and postoperative complication management in infants and toddlers with severe traumatic brain injuries: Clinical article. Journal of Neurosurgery: Pediatrics 2009; 3: 334–9. https://doi.org/10.3171/2008.12.PEDS08310.
[3] Fourcade O, Fuzier R, Daboussi A, Gigaud M, Trémoulet M, Samii K. Craniectomie décompressive et hypertension intracrânienne. Annales françaises d’anesthésie et de réanimation, vol. 25, Elsevier; 2006, p. 858–62.
[4] Stricker PA, Shaw TL, Desouza DG, Hernandez SV, Bartlett SP, Friedman DF, et al. Blood loss, replacement, and associated morbidity in infants and children undergoing craniofacial surgery. Pediatric Anesthesia 2010; 20: 150–9.
[5] Riyaz M, Waqas M, Ujjan BU, Akhunzada NZ, Hadi YB, Javed G, et al. Decompressive craniectomy for infants: a case series of five patients. Childs Nerv Syst 2015; 31: 2117–22. https://doi.org/10.1007/s00381-015-2808-1.
[6] Yue JK, Rick JW, Deng H, Feldman MJ, Winkler EA. Efficacy of decompressive craniectomy in the management of intracranial pressure in severe traumatic brain injury. J Neurosurg Sci. 2019 Aug; 63 (4): 425-440. doi: 10.23736/S0390-5616.17.04133-9. Epub 2017 Nov 7. PMID: 29115100.
[7] Elsawaf Y, Anetsberger S, Luzzi S, Elbabaa SK. Early Decompressive Craniectomy as Management for Severe Traumatic Brain Injury in the Pediatric Population: A Comprehensive Literature Review. World Neurosurg. 2020 Jun; 138: 9-18. doi: 10.1016/j.wneu.2020.02.065. Epub 2020 Feb 19. PMID: 32084616.
[8] Ardissino M, Tang A, Muttoni E, Tsang K. Decompressive craniectomy in paediatric traumatic brain injury: a systematic review of current evidence. Childs Nerv Syst. 2019 Feb; 35 (2): 209-216. doi: 10.1007/s00381-018-3977-5. Epub 2018 Sep 13. PMID: 30215120; PMCID: PMC6351512.
[9] Yamaura A, Sato M, Meguro K, Nakamura T, Uemura K. Cranioplasty following decompressive craniectomy–analysis of 300 cases (author’s transl). No Shinkei Geka Neurological Surgery 1977; 5: 345.
[10] Prasad GL, Gupta DK, Mahapatra AK, Sharma BS. Surgical results of decompressive craniectomy in very young children: A level one trauma centre experience from India. Brain Inj 2015; 29: 1717–24. https://doi.org/10.3109/02699052.2015.1075146.
[11] Ranger A, Szymczak A, Fraser D, Salvadori M, Jardine L. Bilateral Decompressive Craniectomy for Refractory Intracranial Hypertension in a Child with Severe ITP-Related Intracerebral Haemorrhage. PNE 2009; 45: 390–5. https://doi.org/10.1159/000260910.
[12] Rutigliano D, Egnor MR, Priebe CJ, McCormack JE, Strong N, Scriven RJ, et al. Decompressive craniectomy in pediatric patients with traumatic brain injury with intractable elevated intracranial pressure. Journal of Pediatric Surgery 2006; 41: 83–7. https://doi.org/10.1016/j.jpedsurg.2005.10.010.
[13] Yang XF, Wen L, Shen F, Li G, Lou R, Liu WG, et al. Surgical complications secondary to decompressive craniectomy in patients with a head injury: a series of 108 consecutive cases. Acta Neurochirurgica 2008; 150: 1241.
[14] Peiniger S, Nienaber U, Lefering R, Braun M, Wafaisade A, Borgman MA, et al. Glasgow Coma Scale as a predictor for hemocoagulative disorders after blunt pediatric traumatic brain injury. Pediatric Critical Care Medicine 2012; 13: 455–60.
[15] Whittaker B, Christiaans SC, Altice JL, Chen MK, Bartolucci AA, Morgan CJ, et al. Early coagulopathy is an independent predictor of mortality in children after severe trauma. Shock (Augusta, Ga) 2013; 39: 421.
Cite This Article
  • APA Style

    El Hadji Cheikh Ndiaye Sy, Abdoulaye Diop, Yakhya Cisse, Mohameth Faye, Attoumane Fahad, et al. (2021). Decompresive Craniectomy in Infants at Fann University Hospital in Dakar. International Journal of Neurosurgery, 5(1), 8-12. https://doi.org/10.11648/j.ijn.20210501.13

    Copy | Download

    ACS Style

    El Hadji Cheikh Ndiaye Sy; Abdoulaye Diop; Yakhya Cisse; Mohameth Faye; Attoumane Fahad, et al. Decompresive Craniectomy in Infants at Fann University Hospital in Dakar. Int. J. Neurosurg. 2021, 5(1), 8-12. doi: 10.11648/j.ijn.20210501.13

    Copy | Download

    AMA Style

    El Hadji Cheikh Ndiaye Sy, Abdoulaye Diop, Yakhya Cisse, Mohameth Faye, Attoumane Fahad, et al. Decompresive Craniectomy in Infants at Fann University Hospital in Dakar. Int J Neurosurg. 2021;5(1):8-12. doi: 10.11648/j.ijn.20210501.13

    Copy | Download

  • @article{10.11648/j.ijn.20210501.13,
      author = {El Hadji Cheikh Ndiaye Sy and Abdoulaye Diop and Yakhya Cisse and Mohameth Faye and Attoumane Fahad and Maguette Mbaye and Mbaye Thioub and Jean Michel Nzisabira and Lounceny Fatoumata Barry and Rel Gerald Boubaka Kala and Ansoumane Donzo and Abdou Soilihi Ansaou and Nantenin Doumbia and Alioune Badara Thiam and Momar Code Ba and Seydou Boubakar Badiane},
      title = {Decompresive Craniectomy in Infants at Fann University Hospital in Dakar},
      journal = {International Journal of Neurosurgery},
      volume = {5},
      number = {1},
      pages = {8-12},
      doi = {10.11648/j.ijn.20210501.13},
      url = {https://doi.org/10.11648/j.ijn.20210501.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20210501.13},
      abstract = {Introduction: Decompressive craniectomy is a neurosurgical technique indicated as a last resort in the management of intracranial hypertension refractory to medical treatment. Carried out in infants, it represents an additional challenge due to the morbidity and mortality with which it is associated. The objective of our study was to report the experience of the neurosurgery department of Fann University Hospital in Dakar. Patients and Methods: It's a retrospective study on 4 infants who have undergone a decompressive craniectomy at Fann University Hospital in Dakar over a period of 10 years, from January 1, 2010 to December 31, 2020. Results: Four patients under 2 years of age underwent decompressive craniectomy out of a total of 26 patients over the study period. The mean age at diagnosis was 10 months with extreme (60 days to 24 month). The average consultation time was 3 days with extremes (1 to 8 days). Two infants had had severe head trauma. Only one infant showed significant clinical improvement postoperatively; the other three died within 1 to 6 days of surgery. These deaths were linked to acute bleeding in 75% of cases. The mean survival time was 2 days with extremes ranging from 1 to 4 days. Conclusion: Decompresive craniectomy remains the challenge in infants due to the risk of bleeding and hemodynamic instability. Given the low number of publications, we encourage other authors to share their. In our study, three patients died at the end of the operation from bleeding complications. Among these deaths a patient had a coagulopathy which also poses another challenge to the management of these patients.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Decompresive Craniectomy in Infants at Fann University Hospital in Dakar
    AU  - El Hadji Cheikh Ndiaye Sy
    AU  - Abdoulaye Diop
    AU  - Yakhya Cisse
    AU  - Mohameth Faye
    AU  - Attoumane Fahad
    AU  - Maguette Mbaye
    AU  - Mbaye Thioub
    AU  - Jean Michel Nzisabira
    AU  - Lounceny Fatoumata Barry
    AU  - Rel Gerald Boubaka Kala
    AU  - Ansoumane Donzo
    AU  - Abdou Soilihi Ansaou
    AU  - Nantenin Doumbia
    AU  - Alioune Badara Thiam
    AU  - Momar Code Ba
    AU  - Seydou Boubakar Badiane
    Y1  - 2021/03/12
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijn.20210501.13
    DO  - 10.11648/j.ijn.20210501.13
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 8
    EP  - 12
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20210501.13
    AB  - Introduction: Decompressive craniectomy is a neurosurgical technique indicated as a last resort in the management of intracranial hypertension refractory to medical treatment. Carried out in infants, it represents an additional challenge due to the morbidity and mortality with which it is associated. The objective of our study was to report the experience of the neurosurgery department of Fann University Hospital in Dakar. Patients and Methods: It's a retrospective study on 4 infants who have undergone a decompressive craniectomy at Fann University Hospital in Dakar over a period of 10 years, from January 1, 2010 to December 31, 2020. Results: Four patients under 2 years of age underwent decompressive craniectomy out of a total of 26 patients over the study period. The mean age at diagnosis was 10 months with extreme (60 days to 24 month). The average consultation time was 3 days with extremes (1 to 8 days). Two infants had had severe head trauma. Only one infant showed significant clinical improvement postoperatively; the other three died within 1 to 6 days of surgery. These deaths were linked to acute bleeding in 75% of cases. The mean survival time was 2 days with extremes ranging from 1 to 4 days. Conclusion: Decompresive craniectomy remains the challenge in infants due to the risk of bleeding and hemodynamic instability. Given the low number of publications, we encourage other authors to share their. In our study, three patients died at the end of the operation from bleeding complications. Among these deaths a patient had a coagulopathy which also poses another challenge to the management of these patients.
    VL  - 5
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Unit, Ziguinchor Regional Hospital Center, Ziguinchor, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal

  • Sections