Basal cisternostomy for traumatic brain injury: A case report of unexpected good recovery

In subarachnoid hemorrhage following traumatic brain injury (TBI), the high intracisternal pressure drives the cerebrospinal fluid into the brain parenchyma, causing cerebral edema. Basal cisternostomy involves opening of the basal cisterns to atmospheric pressure and draining cerebrospinal fluid in an attempt to reverse the edema. We describe a case of basal cisternostomy combined with decompressive craniectomy. A 35-year-old man with severe TBI following a road vehicle accident presented with acute subdural hematoma, Glasgow coma scale score of 6, fixed pupils and no corneal response. Opening of the basal cisterns and placement of a temporary cisternal drain led to immediate relaxation of the brain. The patient had a Glasgow coma scale score of 15 on postoperative day 6 and was discharged on day 10. We think basal cisternostomy is a feasible and effective procedure that should be considered in the management of TBI. © 2021 Chinese Medical Association

Encarnacion Ramirez M.D.J. , Barrientos Castillo R.E. , Vorobiev A. 2 , Kiselev N.2 , Aquino A.A.3 , Efe I.E.4
Elsevier B.V.
  • 1 Department of Neurosurgery, Russian People's Friendship University, Moscow, Russian Federation
  • 2 Department of Neurosurgery, Municipal Hospital, Podolsk, Russian Federation
  • 3 Department of Neurosurgery, International Center for Neurological Restoration, Havana, Cuba
  • 4 Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
Ключевые слова
Basal cisternostomy; Cerebral edema; Decompressive craniectomy; Neurotrauma; Traumatic brain injury
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