Initial Conservative Management of Severe Hemispheric Stroke Reduces Decompressive Craniectomy Rates.

Background: Pooled European trial results of early decompressive craniectomy (DC) for severe hemispheric stroke did not require radiographic mass effect as an inclusion criterion. Early surgery for supratentorial cerebral hemorrhage does not improve functional status or survival compared to initial conservative medical management. Early versus delayed DC for hemispheric stroke has not been investigated.

Lower complication rates for cranioplasty with peri-operative bundle.

Background: The overall benefits of craniectomy must include procedural risks from cranioplasty. Cranioplasty carries a high risk of surgical site infections (SSI) particularly with antibiotic resistant bacteria. The goal of this study was to measure the effect of a cranioplasty bundle on peri-operative complications.

The genesis of low pressure hydrocephalus.

Background: Low pressure hydrocephalus (LPH) is an uncommon entity. Recognition of this treatable condition is important when clinicians are faced with the paradox of symptomatic hydrocephalus despite low intracranial pressures (ICP). Its etiology remains enigmatic.