Comparison of the effect of decompressive craniectomy on different neurosurgical diseases

Abstract

According to the mortality and GOS scores, decompressive craniectomy with dural expansion was found to be more effective in patients with ICH or TBI than in the MI group. However, the ventricular pressure change during the decompressive craniectomy was similar in the different disease groups. The authors thought that decompressive craniectomy should be performed earlier for the major infarction patients.

Decompressive Craniectomy for Intractable Intracranial Hypertension

“…Most of patients with hemispheric infarctions had unilateral brain swelling and they have 80% mortality rate. Decompressive craniectomy has been shown to reduce this mortality to 20-35% [2,14,15]. Few recent studies on malignant ischemic stroke demonstrate that early surgery even before the pupil dilates may increase the number of patients with a favourable functional outcome [6,16,17].…”

“…In these patients the initial strategy is to repair or to stabilize the primary cause and to decrease the intracranial pressure (ICP) levels to minimise the alterations of both local and total cerebral perfusion [2]. Intracranial hypertension which could not be managed with maximal medical treatment occurs in up to 10 to 15% of these patients.…”

Therapeutic Results of Intra-Arterial Thrombolysis after Full-Dose Intravenous Tissue Plasminogen Activator Administration: Fig 1.

“…Some authors thought that timely performance of surgical intervention for increased intracranial pressure critically decreased the mortality rate. 24 Conventional noncontrast CT remains the mainstay in the imaging of suspected acute stroke. 1,12 However, MR imaging has emerged as an important tool for the identification of patients with cerebral ischemia.…”

Decompressive Craniectomy: Surgical Indications, Clinical Considerations and Rationale

“…These include patients in categories including but not limited to subarachnoid hemorrhage secondary to ruptured aneurysm, intracerebral hemorrhage (ICH), and infectious processes. Kim et al (Ki-Tae Kim 2008) describe a series in which 75 patients underwent decompressive craniectomy and were analyzed retrospectively. In this group 28 patients were classified as traumatic brain injury, 24 as intracerebral hemorrhage and 23 with major infarction.…”