Effect of Decompressive Craniectomy on Perihematomal Edema in Patients with Intracerebral Hemorrhage

Abstract

Background

The risk factors and prognosis of delayed perihematomal edema in patients with spontaneous intracerebral hemorrhage

“…The retrospective baseline data of 121 patients with sICH (Table ) who were admitted to the Department of Neurology of the First Affiliated Hospital of Chongqing Medical University from January 2014 to August 2018 were recruited, of whom 38 patients were males and 83 were females, aged from 18 to 86, the median age being 59. All the included 121 patients were diagnosed with sICH in accordance with American Heart Association guidelines by a head computed tomography(CT) examination within 24 hours after the known time of symptom onset in our hospital, and at least, three more head CT's performed within 24 hours, 5‐9 days, and 12‐20 days after the onset of sICH, retrospectively. All the patients were treated by controlling blood pressure and with conventional dehydration treatment.…”

“…Moreover, the CT value of HE is varying from 44 to 100 Hounsfield units and the PHE is ranging from 5 to 33 Hounsfield units in the head CT. We use the area of every slice on CT multiply the slice thickness and then got the volume of HE and PHE by adding up all results. 2,12 The volume was blindly calculated by two physicians, and these measurements were used to obtain a volume average which was finally used in the analysis. The volume of PHE minus the volume of hematoma is the volume of absolute PHE.…”

“…Spontaneous intracerebral hemorrhage (sICH) is a generally acknowledged disease that accounts for 10%‐15% of all strokes, with high disability and mortality rates in the short term and long term . Growing studies focus on a variety of treatments such as controlling blood pressure, hemostatic therapy, or removing the hematoma through surgery to improve the functional outcome and reduce the mortality rate.…”

Acute Management of Anticoagulation-Associated Intracerebral Hemorrhage

“…Another subanalysis of the INTERACT 2 data examined temperature regulation and edema development and established a linear relationship between edema and ambient temperature, i. e., a higher ambient temperature increased the volume of perihemorrhagic edema [97]. The effect of a decompressive craniectomy was also investigated and did show progressive and prolonged edema after surgery, although the clinical outcome for those patients appeared better [98].…”

Management von schwerwiegenden intrazerebralen Blutungen unter Antikoagulation

“…Eine weitere Subanalyse der INTERACT 2-Daten untersuchte Temperaturregulierung mit Ödementwicklung und konnte einen linearen Zusammenhang zwischen Ödem und Umgebungstemperatur herstellen, d. h. eine erhöhte Umgebungstemperatur führte zu einem größeren peri-hämorrhagischen Ödem [97]. Auch der Einfluss einer dekompressiven Kraniektomie wurde untersucht und zeigte zwar eine progrediente und prolongierte Ödementwicklung nach Operation, jedoch mit vorteilhafterem klinischem Ergebnis für operierte Patienten [98].…”