Decompressive Craniectomy

A decompressive craniectomy is a surgical procedure that removes a part of the skull, which will be replaced at a later date. Once the patient’s brain swelling has subsided and no other complications have developed, then cranioplasty can be performed whereby either the original piece of bone that had been removed and freeze-stored can be put back in place, or an artificial plate may be attached. 

The goal is to relieve pressure in the brain and allow a swollen brain enough room to expand without causing any further damage. Increased intracranial pressure could cause brain herniation which then compromises cerebral blood flow, which can be fatal. This procedure is sometimes performed on victims of traumatic brain injury or for those who have had a massive stroke. 

Surgical Indications for Decompressive Craniectomy 

  • Severe brain swelling – extensive brain infarction
  • High intracranial pressure, despite treatment with medication 
  • Large blood clots inside the head 
All surgical procedures carry some risks, and decompressive craniectomy can cause certain complications, such as: 
  • Intracranial hemorrhage or formation of new blood clots inside the head after surgery
  • Infections such as meningitis or brain abscess 
  • Breathing problems, pneumonia 
In the early stages following surgery, patients must remain in the intensive care unit so that vital signs, level of consciousness and other symptoms can be monitored closely. 

Symptoms Requiring Immediate Medical Attention 

Following surgery, if the patient experiences any of the symptoms below, medical attention should be sought immediately:
  • High fever 
  • Any symptoms indicating infection, such as pain, swelling, or redness 
  • Change in conditions or levels of consciousness, such as decreased alertness or increased drowsiness or tiredness 
  • Muscle weakness in arms and/or legs 
  • Severe headache
  • Vomiting
Neuroscience Center
Bumrungrad International Clinic (BIC) Building, 19th floor
Bumrungrad International Hospital, Bangkok, Thailand

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