Skull removal can help or hurt patients with severe head trauma

Skull removal can help or hurt patients with severe head trauma

Doctors can save the lives of some patients with severe brain injuries through a surgical procedure that involves removing the clients' skulls. It's called decompressive craniectomy, and it can treat victims with head injuries who might otherwise have died. But it is also controversial.

A significant number of patients who receive the surgery die anyway. Some who survive have no cognitive function, and others have impaired motor function and cognitive abilities but can still communicate. The problem is that surgeons can have difficulty telling who might recover and who are likely to be unable to function, and they must make decisions quickly, in emergency rooms and hospitals near battlefields.

Why, given these complications, would surgeons perform the procedure in the first place? Sometimes the procedure has remarkable results. Notable people who have had the procedure include former congressmanwoman Gabrielle Giffords, who was shot in the head, and a U.S. senator who suffered a severe stroke. The senator is now back at work. In another case, an 18-year-old man had a severe stroke while working out. He had a hemicranectomy. He lost function of nearly 2/3 of his right brain from the stroke, but he has recovered well and can walk with a cane.

A neurosurgeon who has authored studies on the effectiveness of the procedure says that more research is needed to determine who will do well and who will not. He says surgeons now have a rough idea, but the results can be surprising.


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