Opportunity of hemilateral craniotomy in treatment of a large area cerebral infarction
- VernacularTitle:偏侧颅骨切除术治疗大面积脑梗死时机的分析
- Author:
Jie SONG
;
Qing JI
;
Huanchang SHI
- Publication Type:Journal Article
- Keywords:
Infarction,middle cerebral artery;
Craniotomy;
Therapy
- From:
Chinese Journal of Postgraduates of Medicine
2008;31(23):12-14
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the opportunity of hemilateral craniotomy in treatment of a large area combined middle cerebral artery (MCA) infarction.Methods Thirty-two patients with a large area combined MCA infarction were performed by hemilateral craniotomy.Initial clinical presentation was evaluated by the Glasgow coma scale(GCS).All survivors were assessed three months after surgical decompression according to Barthel index(BI).The effects of pre-hemia decompressive surgery(before any signs of cerebral hernia,based on clinical status and CT or DWI findings)versus post-hernia surgery (after signs of hernia) on mortality,functional outcome.Results In 18 patients with pre-hernia decompressive surgery,3 patients (16.7%)were dead and average BI was (66.94±7.75)scores.The mortality was 57.1%(8/14)and average BI was (38.43±9.82)scores of post-hernia surgery with 3 cases severe aphasia.Conclusion Hemilateral craniotamy is performed before occurrence of cerebral hernia may decrease the mortality and improve outcome in these patients.
