Surgical Outcomes of Decompressive Craniectomy Versus Hinge Craniotomy in Treatment of Malignant Intracranial Hypertension, A Retrospective Comparative Study

MAHMOUD RAMADAN ADLY, M.D., MAGED A. ELGEBALY, M.D.; MOHAMED S. ABDELAZIZ, M.D. And

doi:10.21608/mjcu.2025.444591

Surgical Outcomes of Decompressive Craniectomy Versus Hinge Craniotomy in Treatment of Malignant Intracranial Hypertension, A Retrospective Comparative Study

Document Type : Original Article

Author

MAGED A. ELGEBALY, M.D.; MOHAMED S. ABDELAZIZ, M.D. and MAHMOUD RAMADAN ADLY, M.D.

The Department of Neurosurgery, Faculty of Medicine, Beni-Suef University

10.21608/mjcu.2025.444591

Abstract

Background: Malignant intracranial hypertension (MIH) remains a critical neurosurgical emergency requiring timely intervention to prevent irreversible brain damage. While de-compressive craniectomy (DC) is a well-established approach, hinge craniotomy (HC) has emerged as a potential alternative that may reduce the need for secondary procedures. Aim of Study: To compare decompressive craniectomy (DC) and hinge craniotomy (HC) in managing malignant in-tracranial hypertension (MIH). Patients and Methods: Retrospective analysis of 40 pa-tients (20 DC, 20 HC) treated at Beni-Suef University Hos-pitals (June 2023 – June 2024). Outcomes included Glasgow Outcome Scale (GOS), complications, ICU/hospital stay, and radiographic parameters. Results: No baseline differences in age, gender, or pre-op GCS (p>0.05). HC showed a trend toward better GOS, with 70% of outcomes being favourable compared to 50% (p=0.13). Complication rates (infection: HC 15% vs. DC 25%, p=0.42) and ICU stays (HC 7.6±2.1 vs. DC 7.8±1.9 days, p=0.75) were comparable. Conclusions: HC may offer comparable or superior out-comes to DC, avoiding secondary cranioplasty. More extensive prospective studies are needed.

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