Curriculum Resources

Neurointensive Care - Capability Levels and Curriculum Reference for Stages 1-3

Indications for Decompressive Craniectomy

Published on 18 March, 2022

Last modified on May 12th, 2023

Curriculum Reference

15.9.2 (B) delivers safe peri-operative anaesthetic care to adults for emergency intracranial surgery, CSF diversions, spinal surgery an endovasvular thrombectomy.

HiLLO 12: Doctors specialising in Intensive Care Medicine understand the special needs of, and are competent to manage patients with neurological diseases, both medical and those requiring surgery, which will include the management of raised intracranial pressure, central nervous system infections and neuromuscular disorders.

Further Reading and Key Trials

Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial

Sequential-Design, Multicenter, Randomized, Controlled Trial of Early Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction (DECIMAL Trial)

Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery (DESTINY)

Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension (RESCUE-ICP)

RESCUE-ASDH decompressive craniotomy vs craniotomy for acute subdural haematoma

National Guidance/Standards

Red flag for diagnosing death with neurological criteria following decompression

Diagnosing Death using Neurological Criteria | The Faculty of Intensive Care Medicine (


Decompressive craniectomy for Malignant MCA infarction • LITFL• CCC

RCoA Audit Compendium

FICM Standard

Adults under the age of 60 with middle cerebral artery infarction admitted to intensive must have access to a decompressive craniectomy service at a specialist neurosciences centre.

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