EBRAHIMI NEJAD A, SEDIGHI B, HOSSEIN NAKHAEE F. THE EFFICACY OF DECOMPRESSIVE CRANIECTOMY IN TREATMENT OF PATIENTS WITH MASSIVE HEMISPHERIC CEREBRAL INFARCTION. Med J Islam Repub Iran 2004; 18 (1) :7-11
URL:
http://mjiri.iums.ac.ir/article-1-645-en.html
From the Departments ofNeurosurgery, Neurology, and Bio-Statistics & Epidemiology. Kerman University of Medical Sciences, Kerman, fran
Abstract: (4342 Views)
Massive cerebral infarction is often accompanied by early death, secondary to
brain edema and trans-tentorial herniation. Several reports indicate beneficial effects of
decompressive craniectomy in this situation, but the efficacy of this procedure is still a
matter of debate.
A n experimental study in a period of3 years was done on2 3 patients with brain
edema due to massive cerebral infarction 11 patients were subjects and were operated,
and1 2 were in the non-operated group who only underwent conservative treatment.
A ll patients in this study had GCS below 8.
The m ean age of the operated patients was 54.5 yea r s and f o r the
unoperated patients 64.4 yea r s. Mean GCS in the operated cases was 7.00
and in the unoperated cases was 7.66. In the operated g r o up 4 of 11 patient s
lived (36.4%) and in the u l10perated group1 o f1 2 cases lived ( 8.3%). I n the
living operated cases, 1 had GOS 4 and 3 cases had GOS 3. In unoperated
cases 1 patient lived that had a GOS of2.
These results show that decompressive craniectomy can be an effective lifesaving
procedure for malignant brain edema after cerebral infarction and can also give acceptable
functional recovery.