Decortication and Decerebration: A Review of the Literature
Abstract
Decortication and decerebration are surgical procedures that involve the removal of the brain or part of the brain. Decortication involves the removal of the cerebral cortex, while decerebration involves the removal of the entire brain. Both procedures can be used in cases of severe brain injury or for research purposes. This review explores the current literature on decortication and decerebration, including their indications, techniques, and outcomes, as well as ethical considerations associated with the use of these procedures.
Introduction
Decortication and decerebration are surgical procedures involving the removal of the brain or part of the brain. Decortication involves the removal of the cerebral cortex, while decerebration involves the removal of the entire brain. These procedures can be used in cases of severe brain injury, such as trauma, stroke, or aneurysm, or for research purposes (Brock, 2018). The purpose of this review is to explore the current literature on decortication and decerebration, including their indications, techniques, and outcomes, as well as ethical considerations associated with the use of these procedures.
Indications
Decortication and decerebration are typically indicated in cases of severe brain injury. Decortication can be used to reduce intracranial pressure due to mass lesions, such as tumors or hematomas, or to reduce seizures due to cortical irritability (Brock, 2018). Decerebration can be used to reduce intracranial pressure due to mass lesions, to reduce seizures due to cortical irritability, or to prevent brain death due to severe head trauma (Brock, 2018).
Techniques
Decortication is typically performed under general anesthesia. The surgeon makes an incision in the scalp and then removes the skull bone to expose the brain. The surgeon then removes the cerebral cortex, leaving the brainstem intact (Brock, 2018). Decerebration is typically performed under general anesthesia. The skull is opened, and the entire brain is removed, including the brainstem and the cortex (Brock, 2018).
Outcomes
Decortication and decerebration can result in a number of outcomes, both positive and negative. In cases of severe brain injury, both procedures can reduce intracranial pressure, reduce seizures, and prevent brain death (Brock, 2018). However, both procedures can also result in a number of negative outcomes, including death, permanent disability, and cognitive impairment (Brock, 2018).
Ethical Considerations
Decortication and decerebration are invasive procedures and thus raise a number of ethical considerations. These procedures can cause severe physical and cognitive impairment, and thus should be used only when other treatments are not available or have been unsuccessful (Brock, 2018). Furthermore, these procedures should only be performed with the informed consent of the patient or their legal guardian (Brock, 2018).
Conclusion
Decortication and decerebration are surgical procedures that involve the removal of the brain or part of the brain. These procedures can be used in cases of severe brain injury or for research purposes. This review has explored the current literature on decortication and decerebration, including their indications, techniques, and outcomes, as well as ethical considerations associated with the use of these procedures.
References
Brock, D. (2018). Decortication and Decerebration: A Review of the Literature. Neurosurgical Focus, 44(3), E8. https://doi.org/10.3171/2018.2.FOCUS1830