Decompressive craniectomy in massive cerebral infarction

• Autor(a) principal: Mattos,João Paulo
• Data de Publicação: 2010
• Outros Autores: Joaquim,Andrei Fernandes, Almeida,João Paulo Cavalcante de, Albuquerque,Lucas Alverne Freitas de, Silva,Élton Gomes da, Marenco,Horácio Armando, Oliveira,Evandro de
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Arquivos de neuro-psiquiatria (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2010000300002
• topic: cerebral infarction; decompressive hemicraniectomy; surgical decompression

Twenty one patients were submitted to decompressive craniectomy for massive cerebral infarct. Ten patients (47.6%) presented a good outcome at the 6 months evaluation, eight had a poor outcome (38%) and three died (14.2%). There was no outcome statistical difference between surgery before and after 24 hours of ictus, dominant and non-dominant stroke groups. Patients older than 60 years and those who had a Glasgow Coma Scale (GCS)<8 in the pre-surgical exam presented worst outcome at six months (p<0.05). Decompressive craniectomy for space-occupying large hemispheric infarction increases the probability of survival. Age lower than 60 years, GCS >8 at pre-surgical exam and decompressive craniectomy before signs of brain herniation represent the main factors related to a better outcome. Dominant hemispheric infarction does not represent exclusion criteria.