Abstract:

Acute brain bulge is a critical phenomenon in open surgery for traumatic brain injury（TBI）， with common causes including delayed hematoma， massive cerebral infarction and diffuse cerebral swelling， the prognosis is usually very poor. In recent years， with the promotion and application of the concept of controlled intracranial decompression （CID） and related technologies， the incidence of intraoperative brain bulge has decreased significantly. However， some patients still suffer from brain bulge， especially those with severe diffuse cerebral swelling. Traumatic brain swelling （TBS） is an important basis for primary brain bulge， and the pathological mechanisms of both are complex. Therefore，the clinical efficacy of CID technology should be viewed rationally， and new theories and mechanisms of TBS should be explored. This article mainly reviews the mechanisms of TBS and primary brain bulge， the operational principles of CID technology， and its preventive mechanism and effect， with the aim of providing reference for improving the success rate of surgery for TBI patients.

Key words: Traumatic brain injury, Acute brain bulge, Controlled decompression technique, Traumatic brain swelling, Cerebral hemodynamics