Decompressive Craniectomy in a Patient with Severe Traumatic Brain Injury during Mild Therapeutic Hypothermia

Caballero A, Magaldi M^*, Jacas A, Calvo A and Fontanals J

Anaesthesia Department, Hospital Clinic, University of Barcelona, Spain

*Corresponding Author : Marta Magaldi, MD
Anaesthesia and Critical Care Department, Hospital Clinic, University of Barcelona, Villarroel, 170. 08036, Barcelona, Spain
Tel: (+34) 932275400 (ext 5558)
E-mail: mmagaldi@clinic.ub.es

Received: April 05, 2016 Accepted: May 23, 2017 Published: May 30, 2017

Citation: Caballero A, Magaldi M, Jacas A, Calvo A, Fontanals J (2017) Decompressive Craniectomy in a Patient with Severe Traumatic Brain Injury during Mild Therapeutic Hypothermia. Analg Resusc: Curr Res 6:1. doi:10.4172/2324-903X.1000146

Mild Therapeutic Hypothermia (MTH) and decompressive craniectomy are therapeutic measures used for the treatment of intracranial hypertension (ICHT) refractory to medical treatment and cerebrospinal fluid drainage. One of the side effects of MTH is the increased risk of coagulopathy, thus the performance of neurosurgical procedures in these cases is very controversial.We present the case of a patient with traumatic brain injury and ICHT refractory to medical treatment, in which moderate therapeutic hypothermia was initiated. After a transient improvement, the patient presented ICHT again, requiring a decompressive craniotomy while keeping the patient in moderate hypothermia. Due to the history of traumatic brain injury and the use of MTH, we decided on the use of viscoelastic tests as goal-directed therapy to assess haemostasis prior to surgery.