Decompressive Craniectomy for Acute Cerebral Infarction.
- Author:
Heung Sun LEE
;
Won Han SHIN
;
Soon Kwan CHOI
;
Bark Jang BYUN
;
In Soo LEE
- Publication Type:Original Article
- Keywords:
Cerebral infarction;
Brain edema;
Brain swelling;
Decompressive craniectomy;
Prognosis
- MeSH:
Brain Edema;
Cerebral Infarction*;
Decompressive Craniectomy*;
Female;
Hemiplegia;
Humans;
Infarction;
Magnetic Resonance Imaging;
Male;
Persistent Vegetative State;
Prognosis;
Pupil
- From:Journal of Korean Neurosurgical Society
1991;20(10-11):854-859
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We present a series of 10 Patients(Seven men and three women with an average age of 53 years) who underwent decompressive craniectomy for treatment to massive brain swelling following acute cerebral infarction. Clinical signs of cerebral herniation(anisocoria or fixed and dilated pupil, and/or hemiplegia with decerebrate righidity) were present in all patients. Computed tomography and magnetic resonance imaging showed the mass effect by cerebral edema through midline shift. All patients were treated with an extensive craniectomy and duroplasty. Among them, one recovered without neurological deficit, three were moderately disabled but functionally dependent, three remained in a persistent vegetative state and three died within 9 days after surgery(good recovery=1, moderate disability=3, persistent vegetative state=3, death=3). The results suggest that decompressive craniectomy can be an useful lifesaving procedure for massive cerebral edema following widespread hemispheric infarction.
