Indications And Outcomes Of Decompressive Craniectomy. Considerations From Clinical And Medical Ethics Perspectives

Decompressive craniectomy (DC) is a neurosurgical intervention that entails removing a section of the skull to alleviate intracranial pressure (ICP) in patients with intracranial hypertension that does not respond to standard medical treatments. Although widely utilized in clinical practice, its indications, effectiveness, and functional outcomes continue to be topics of discussion in neurocritical care. This paper provides a review of the literature on the results of DC in various severe neurological conditions and explores the ethical challenges associated with its use. We analyze the indications for decompressive craniectomy in various neurosurgical conditions, assessing its outcomes in terms of survival and functional recovery. Additionally, we present considerations from a bioethical perspective, emphasizing a principlist and personalist approach. Our aim is to provide reflections that may assist healthcare professionals in the complex decision-making process inherent to these clinical scenarios. Keywords: decompressive craniectomy, outcomes, clinical bioethics, neurosurgery.