<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2304-0106</journal-id>
<journal-title><![CDATA[Anales de la Academia de Ciencias de Cuba]]></journal-title>
<abbrev-journal-title><![CDATA[Anales de la ACC]]></abbrev-journal-title>
<issn>2304-0106</issn>
<publisher>
<publisher-name><![CDATA[Academia de Ciencias de Cuba]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2304-01062022000300031</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Craniectomía descompresiva en el neurotrauma grave]]></article-title>
<article-title xml:lang="en"><![CDATA[Decompressive craniectomy in severe neurotrauma]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lacerda Gallardo]]></surname>
<given-names><![CDATA[Angel J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abreu Pérez]]></surname>
<given-names><![CDATA[Daisy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General Docente Roberto Rodríguez Servicio de Neurocirugía ]]></institution>
<addr-line><![CDATA[Morón Ciego de Ávila]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Academia de Ciencias de Cuba  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General Docente Roberto Rodríguez Servicio de Cuidados Intensivos Pediátricos ]]></institution>
<addr-line><![CDATA[Morón Ciego de Ávila]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>12</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S2304-01062022000300031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S2304-01062022000300031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S2304-01062022000300031&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La hipertensión intracraneal es un factor de mal pronóstico en el traumatismo craneoencefálico grave, la craniectomía descompresiva es un procedimiento en controversia que puede reducir la presión intracraneal de forma rápida por lo que planteamos el siguiente problema de investigación: ¿Podrá la craniectomía descompresiva reducir el daño cerebral secundario y disminuir la mortalidad de estos enfermos?  Métodos:  Se realizó un estudio correlacional descriptivo con 230 casos admitidos entre el 2007 y 2020, en el servicio de neurocirugía del Hospital General Docente Roberto Rodríguez de Morón, Ciego de Àvila, Cuba, a los que se les realizó craniectomía descompresiva precoz, en las primeras 12 h de evolución del trauma, como medida para controlar la presión intracraneal.  Resultados:  El 50,87 % mostró cifras de presión intracraneal inferiores a 20 mm Hg en las primeras 24 h del post operatorio, incrementándose hasta un 73,48 % entre el segundo y el quinto día, de los cuales el 75,74 % obtuvo resultados satisfactorios. El 82,17 % mantuvo la presión de perfusión cerebral por encima de 60 mm Hg y solo el 17,83 % tuvo un patrón hemodinámico isquémico. La mortalidad fue del 28,69 %. Como conclusiones, se propone una &#8220;ventana quirúrgica&#8221; de 12 h para la craniectomía descompresiva en el trauma craneoencefálico grave, se incrementa el diámetro de la craniectomía a más de 15 cm3 y se convierte en una medida terapéutica de primer nivel. El tipo de craniectomía descompresiva fue seleccionado de acuerdo con el tipo y localización de la lesión intracraneal.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction.  Increased intracranial pressure is a poor prognosis factor in patients with severe head trauma. Decompressive craniectomy is a surgical procedure that can reduce the intracranial hypertension sooner; we posed the following research problem: Could decompressive craniectomy reduce the secondary brain damage and reduce mortality?  Methods.  A descriptive correlational study was carried out with 230 cases admitted between 2007 and 2020, in the neurosurgery service of the General Teaching Hospital Roberto Rodríguez in Morón, Ciego de Àvila, Cuba, who underwent early decompressive craniectomy, in the first 12 h of evolution of the trauma, as a measure to control intracranial pressure.  Results and Discussion. 50,87 % of the cases showed intracranial pressure lower than 20 mmHg over the first 24 h after surgery, increasing to 73,48 % between the 2nd and 5th day, of which 75,74 % obtained satisfactory results. Decompression allowed 82,17 % to maintain cerebral perfusion pressure above 60 mmHg and only 17,83 % to have an ischemic cerebral hemodynamic pattern. Mortality was 28,69 %. As a conclusion, a 12 h &#8220;surgical window&#8221; is proposed for decompressive craniectomy in severe head trauma, the diameter of the craniectomy is increased to more than 15 cm3, and it becomes a first-level therapeutic measure. The type of decompressive craniectomy was selected according to the type and location of the intracranial lesion.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Traumatismo Craneoencefálico]]></kwd>
<kwd lng="es"><![CDATA[Craniectomía descompresiva]]></kwd>
<kwd lng="es"><![CDATA[Hipertensión intracraneal]]></kwd>
<kwd lng="es"><![CDATA[Escala de coma de Glasgow]]></kwd>
<kwd lng="en"><![CDATA[head trauma]]></kwd>
<kwd lng="en"><![CDATA[decompressive craniectomy]]></kwd>
<kwd lng="en"><![CDATA[intracranial hypertension]]></kwd>
<kwd lng="en"><![CDATA[Glasgow Coma Scale]]></kwd>
</kwd-group>
</article-meta>
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