Second episode of swelling following craniotomy, TBI


I have a patient who was in a MVA 11 weeks ago. A craniotomy was done to relieve ICP after responsiveness was lost and the R pupil blew. Scans revealed brain bleed.The patient has a skin flap over the right side of the head. The bone is frozen, awaiting a decrease in brain swelling.

A significant decrease in swelling occurred gradually between weeks 4 and 8 following the craniotomy. Only a small mass protruding on the lower aspect of the site was present, the upper 3/4 appearing concave. Bruising healed.

Now, however, the swelling has increased back to nearly the progress at week 4. The entire site is enlarged.

What would cause this apparent backtrack in recovery?

mindy kaling, BSN, RN

1 Article; 39 Posts

Specializes in ICU. Has 6 years experience.

It could be from increased ICP, maybe the patient needs interventions to decrese pressure..e.g : mannitol or 3%

Am curious to know what happened


2,095 Posts

What was the patient's neuro assessment status from the time of the decrease in swelling to their current condition?