Arab Board Neurosurgery Final Clinical & Oral Practice Questions - Arab Board Of Health Specializations (ABHS) Neurosurgery Final Clinical And Oral Examination Exam

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A 45-year-old male with severe traumatic brain injury develops refractory intracranial hypertension with ICP persistently exceeding 28 mmHg despite head elevation, sedation, neuromuscular blockade, CSF drainage via an external ventricular drain, and hyperosmolar therapy (serum osmolarity 316 mOsm/L). Brain CT demonstrates diffuse hemispheric swelling with effaced basal cisterns. According to the RESCUEicp trial, what is the next appropriate surgical intervention?

Bilateral subtemporal burr holes without dural opening Decompressive hemicraniectomy with expansile duraplasty Lumbar drain placement for continuous CSF drainage Endoscopic fenestration of the lamina terminalis

Correct Answer:

Decompressive hemicraniectomy with expansile duraplasty

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