Sean Xin, DO: No relevant financial relationships with any proprietary interests.
Learning Objectives:
1. Explain the Mechanistic Rationale and Historical Evolution of Cisternostomy
Learners will be able to describe the pathophysiological basis of cisternostomy, including the role of CSF shift edema and glymphatic dysfunction, and contrast it with the historical use and limitations of decompressive craniectomy.
2. Describe the Operative Technique and Anatomic Landmarks of Basal Cisternostomy
By the end of the session, participants will be able to outline the key steps in performing a cisternostomy—including skull base access, Liliequist membrane dissection, and cisternal drainage placement—using a pterional approach.
3. Evaluate the Current Evidence and Clinical Outcomes Supporting Cisternostomy in Severe TBI
Attendees will critically appraise data from cohort studies and recent randomized controlled trials comparing cisternostomy to decompressive craniectomy, with respect to mortality, ICP control, ventilator days, GOS-E scores, and long-term quality of life.
