BILATERAL DECOMPRESSIVE CRANIECTOMY FOR WORSENING COMA IN ACUTE SUBARACHNOID HEMORRHAGE - OBSERVATIONS IN SUPPORT OF THE PROCEDURE

Bilateral craniectomy in a woman comatose and decerebrate after a suba rachnoid hemorrhage, resulted in normal mentation in 3 days. The drama tic recovery is unmatched in our experience. The rationale rested on c linicopathologic studies showing that in such cases brain swelling was the cause of death, the brain being otherwise intact. Emergency surge ry to relieve the tamponade seemed reasonable. The question is whether the procedure has a role in those patients who fail to respond to cur rent therapeutic measures. The arguments in favor, presented herein, a re illustrated by three pathologic studies selected from our longtime experience.