Prognosis of the decompressive craniectomy for stroke according to preoperative computed tomography


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Guvenc G., KIZMAZOĞLU C., Uzunoglu I.

ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, cilt.10, sa.4, ss.431-435, 2019 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 10 Sayı: 4
  • Basım Tarihi: 2019
  • Doi Numarası: 10.4328/acam.5951
  • Dergi Adı: ANNALS OF CLINICAL AND ANALYTICAL MEDICINE
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI)
  • Sayfa Sayıları: ss.431-435
  • Anahtar Kelimeler: Basal cistern, Decompressive Craniectomy, Mortality, Stroke, MIDDLE-CEREBRAL-ARTERY, HEMORRHAGIC TRANSFORMATION, SURGICAL DECOMPRESSION, MALIGNANT INFARCTION, ISCHEMIC-STROKE, HEMICRANIECTOMY, MULTICENTER, SURGERY, TRIAL
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Aim: The aim of this study was to investigate the preoperative clinic and radiologic signs which affect the prognosis after decompressive craniectomy for stroke. Material and Method: We retrospectively analyzed the demographic and radiological images of patients who underwent decompressive craniectomy for internal carotid artery (ICA) and middle cerebral artery (MCA) strokes. Seventeen patients analyzed retrospectively between January 2012 and December 2015 at our hospital. Results: A total of 17 decompressive craniectomies were performed for supratentorial ischemic strokes: 3 (17.6%) ICA and 14 (82.4%) MCA stroke patients. There were 11 (64.7%) males and 6 (35.3%) females with a mean age of 59.35 +/- 15.39 years (range 20-83 years). There were 10 (58.9%) mortalities. Seven patients were discharged home. The patients' Glasgow Coma Scale, infarct type, dominant hemisphere side, preoperative cranial tomography shift, hemorrhagic transformation, basal cistern, transcalvarial herniation were analyzed. Basal cisterns of 8 (47.1%) patients were open, of 9 (52.9%) patients were closed before decompressive craniectomy. There was a statistically significant difference between mortality rate between open cistern versus closed basal cistern (p=0.029). Discussion: In our study, open cisterns were associated with good outcomes. Larger studies should be performed in the the future.