Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury

Jon D. Dorfman, Joseph D. Burns*, Deborah M. Green, Christina DeFusco, Suresh Agarwal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background Intracranial hypertension is a crucial modifiable risk factor for poor outcome after traumatic brain injury (TBI). Limited evidence suggests that decompressive laparotomy may be an effective treatment for refractory ICH in patients who have elevated intraabdominal pressure. Methods Case report. Results We present a multi-trauma patient who sustained severe TBI in a motor vehicle collision. Intracranial pressure (ICP) was initially medically managed but became refractory to standard therapies. Emergent decompressive laparotomy performed in the surgical intensive care unit for abdominal compartment syndrome concomitantly improved the patient's ICP. Conclusions Elevated intra-abdominal pressure can exacerbate intracranial hypertension in patients with TBI. Recognition of this condition and treatment with decompressive laparotomy may be useful in patients with intracranial hypertension refractory to optimal medical therapy.

Original languageEnglish
Pages (from-to)516-518
Number of pages3
JournalNeurocritical Care
Issue number3
StatePublished - Dec 2011
Externally publishedYes


  • Intra-abdominal hypertension
  • Intracranial hypertension
  • Traumatic brain injury


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