{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:24:44Z","timestamp":1782278684571,"version":"3.54.5"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"13","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,9,29]]},"abstract":"\n BACKGROUND<\/jats:title>\n Basal cisternostomy (BC) is increasingly utilized for intracranial pressure (ICP) management in severe traumatic brain injury (TBI), particularly by neurosurgeons in some high-incidence regions like India and China. It is performed as an adjunct to decompressive craniectomy (DC) or as a stand-alone procedure with bone flap replacement if brain laxity permits after basal cisternal drain placement. Emerging research from regions where this method is used supports its efficacy for ICP control.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 17-year-old male was involved in a severe road traffic accident. He presented with a Glasgow Coma Scale score of 5 and bilaterally dilated, nonreactive pupils. CT revealed a left acute subdural hematoma (ASDH) with significant midline shift, severe global brain edema, effaced basal cisterns, and brainstem compression signs. Emergency BC was performed, followed by ASDH evacuation. The bone flap was replaced. Postoperatively, the patient showed remarkable recovery, with extubation on day 2 and early mobilization. By day 7, he was walking with assistance, and by discharge on day 13, he exhibited only mild word-finding difficulty, which improved significantly at follow-up.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case highlights the potential of BC as an alternative or adjunct to DC in severe TBI, emphasizing the need for larger, multicenter studies to validate its efficacy.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25170<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25170","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:02:27Z","timestamp":1759795347000},"source":"Crossref","is-referenced-by-count":2,"title":["Basal cisternostomy for severe traumatic brain injury: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5375-148X","authenticated-orcid":true,"given":"Afsal","family":"Sharafudeen","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University, Hidaka, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kokyou","family":"Sakurada","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University, Hidaka, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuya","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University, Hidaka, Saitama, Japan"},{"name":"Department of Neurosurgery, Kansai Medical University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Jbarah","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University, Hidaka, Saitama, Japan"},{"name":"Department of Neuroscience, Jordan University of Science and Technology, Irbid, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaima","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University, Hidaka, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8676-1147","authenticated-orcid":true,"given":"Mario","family":"Ganau","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iype","family":"Cherian","sequence":"additional","affiliation":[{"name":"Institute of Neurosciences, Krishna Vishwa Vidyapeeth, Karad, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1216-8695","authenticated-orcid":true,"given":"Hiroki","family":"Kurita","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University, Hidaka, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Asian J Neurosurg","first-page":"132","article-title":"Cisternostomy: replacing the age old decompressive hemicraniectomy?","volume":"8","author":"Cherian","year":"2013","unstructured":"Cherian IYi GMunakomi S.Cisternostomy: replacing the age old decompressive hemicraniectomy? Asian J Neurosurg. 2013;8(3):132-138."},{"issue":"1","key":"bib2","series-title":"Acta Neurochir (Wien)","first-page":"200","article-title":"Cisternostomy is not beneficial to reduce the occurrence of post-traumatic hydrocephalus in traumatic brain injury","volume":"166","author":"Liu","year":"2024","unstructured":"Liu JZhang SChen YCisternostomy is not beneficial to reduce the occurrence of post-traumatic hydrocephalus in traumatic brain injury. Acta Neurochir (Wien). 2024;166(1):200."},{"issue":"2","key":"bib3","series-title":"Chin J Traumatol","first-page":"118","article-title":"The basal cisternostomy for management of severe traumatic brain injury: a retrospective study","volume":"28","author":"Han","year":"2025","unstructured":"Han TJia ZZhang XThe basal cisternostomy for management of severe traumatic brain injury: a retrospective study. Chin J Traumatol. 2025;28(2):118-123."},{"key":"bib4","series-title":"World Neurosurg","first-page":"e58","article-title":"Cisternostomy versus decompressive craniectomy for the management of traumatic brain injury: a randomized controlled trial","volume":"162","author":"Chandra","year":"2022","unstructured":"Chandra VVRMowliswara Prasad BCBanavath HNChandrasekhar Reddy K.Cisternostomy versus decompressive craniectomy for the management of traumatic brain injury: a randomized controlled trial. World Neurosurg. 2022;162:e58-e64."},{"issue":"2","key":"bib5","series-title":"Neurol India","first-page":"328","article-title":"Basal cisternostomy\u2014a microsurgical cerebro spinal fluid let out procedure and treatment option in the management of traumatic brain injury. 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World Neurosurg. 2019;131:385-390."},{"issue":"4","key":"bib16","series-title":"J Neurosurg","first-page":"895","article-title":"Early versus delayed cranioplasty after decompressive craniectomy in traumatic brain injury: a multicenter observational study within CENTER-TBI and Net-QuRe","volume":"141","author":"Vreeburg","year":"2024","unstructured":"Vreeburg RJGSingh RDvan Erp van IAMEarly versus delayed cranioplasty after decompressive craniectomy in traumatic brain injury: a multicenter observational study within CENTER-TBI and Net-QuRe. J Neurosurg. 2024;141(4):895-907."},{"issue":"10","key":"bib17","series-title":"Br J Oral Maxillofac Surg","first-page":"944","article-title":"Role of timing of cranioplasty in improving Neurological functional outcome","volume":"62","author":"Tomar","year":"2024","unstructured":"Tomar KRoy IDKumar Singh AYadav Rekha C.Role of timing of cranioplasty in improving Neurological functional outcome. 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Acta Neurochir (Wien). 1991;112(1-2):28-36."},{"issue":"3-4","key":"bib24","series-title":"Acta Neurochir (Wien)","first-page":"87","article-title":"The role of ventricular and cisternal drainage in the early operation for ruptured intracranial aneurysms","volume":"88","author":"Sakaki","year":"1987","unstructured":"Sakaki SOhta SKuwabara HShiraishi M.The role of ventricular and cisternal drainage in the early operation for ruptured intracranial aneurysms. Acta Neurochir (Wien). 1987;88(3-4):87-94."},{"issue":"1","key":"bib25","series-title":"Neurosurgery","first-page":"8","article-title":"Cisternal drainage after early operation of ruptured intracranial aneurysm","volume":"20","author":"Kawakami","year":"1987","unstructured":"Kawakami YShimamura Y.Cisternal drainage after early operation of ruptured intracranial aneurysm. Neurosurgery. 1987;20(1):8-14."},{"issue":"1-2","key":"bib26","series-title":"Acta Neurochir (Wien)","first-page":"18","article-title":"Enhanced cisternal drainage and cerebral vasospasm in early aneurysm surgery","volume":"80","author":"Ito","year":"1986","unstructured":"Ito UTomita HYamazaki STakada YInaba Y.Enhanced cisternal drainage and cerebral vasospasm in early aneurysm surgery. Acta Neurochir (Wien). 1986;80(1-2):18-23."},{"key":"bib27","series-title":"World Neurosurg","first-page":"e184","article-title":"Case series and systematic review of electronic scooter crashes and severe traumatic brain injury","volume":"167","author":"Azab","year":"2022","unstructured":"Azab MGamboa NNadel JCase series and systematic review of electronic scooter crashes and severe traumatic brain injury. World Neurosurg. 2022;167:e184-e195."},{"key":"bib28","series-title":"Clin Neurol Neurosurg","first-page":"107389","article-title":"What are we measuring? 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Asian J Neurosurg. 2013;8(3):132-138."},{"issue":"1","key":"bib2","series-title":"Acta Neurochir (Wien)","first-page":"200","article-title":"Cisternostomy is not beneficial to reduce the occurrence of post-traumatic hydrocephalus in traumatic brain injury","volume":"166","author":"Liu","year":"2024","unstructured":"Liu JZhang SChen YCisternostomy is not beneficial to reduce the occurrence of post-traumatic hydrocephalus in traumatic brain injury. Acta Neurochir (Wien). 2024;166(1):200."},{"issue":"2","key":"bib3","series-title":"Chin J Traumatol","first-page":"118","article-title":"The basal cisternostomy for management of severe traumatic brain injury: a retrospective study","volume":"28","author":"Han","year":"2025","unstructured":"Han TJia ZZhang XThe basal cisternostomy for management of severe traumatic brain injury: a retrospective study. 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Neurol India. 2021;69(2):328-333."},{"issue":"2","key":"bib6","series-title":"Surgeries","first-page":"283","article-title":"The role of cisternostomy in the management of severe traumatic brain injury: a triple-center study","volume":"4","author":"Encarnaci\u00f3n Ramirez","year":"2023","unstructured":"Encarnaci\u00f3n Ramirez MBaez IPMarszal Mangbel\u2019 Mikorska HThe role of cisternostomy in the management of severe traumatic brain injury: a triple-center study. Surgeries. 2023;4(2):283-292."},{"issue":"3","key":"bib7","series-title":"Acta Neurochir (Wien)","first-page":"469","article-title":"Implementation of cisternostomy as adjuvant to decompressive craniectomy for the management of severe brain trauma","volume":"162","author":"Giammattei","year":"2020","unstructured":"Giammattei LStarnoni DMaduri RImplementation of cisternostomy as adjuvant to decompressive craniectomy for the management of severe brain trauma. 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