open access

Vol 44, No 2 (2010)
ARTYKUŁ ORYGINALNY
Submitted: 2009-05-06
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Decompressive hemicraniectomy in ischaemic stroke

Maciej Świat, Magdalena Targosz-Gajniak, Michał Arkuszewski, Małgorzata Pięta, Jacek Gamrot, Maciej Wojtacha, Piotr Bażowski, Grzegorz Opala
DOI: 10.1016/S0028-3843(14)60004-9
·
Neurol Neurochir Pol 2010;44(2):131-138.

open access

Vol 44, No 2 (2010)
ARTYKUŁ ORYGINALNY
Submitted: 2009-05-06

Abstract

Background and purpose

Hemispheric ischaemic stroke complicated by oedema is associated with high mortality. The results of randomized studies showed that decompressive hemicraniectomy performed in this group of patients could be beneficial. First experiences with implementation of hemicraniectomy in patients with brain infarct in our stroke centre are presented.

Material and methods

Between August 2007 and July 2008, four patients with hemispheric brain infarcts complicated by malignant oedema underwent decompressive hemicraniectomy within 72 hours from symptoms onset. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Clinical outcome was assessed 3, 6 and 12 months after the event using the modified Rankin scale (mRS).

Results

In the first patient, the neurosurgical procedure included only decompressive hemicraniectomy, whereas in the other three duraplasty was performed additionally. The first patient died 23 days after the stroke onset due to acute respiratory failure. Another died at four months after the event, due to infectious complications. The remaining two patients presented severe functional disability 12 months after the procedure (mRS score 4).

Conclusions

Decompressive surgery with duraplasty can be a life-saving procedure for patients with brain oedema. To our knowledge, the presented cases are among the first reported cases of hemispheric ischaemic stroke treated with decompressive hemicraniectomy in Poland. Extended follow-up with a larger group of patients is necessary to assess long-term outcome.

Abstract

Background and purpose

Hemispheric ischaemic stroke complicated by oedema is associated with high mortality. The results of randomized studies showed that decompressive hemicraniectomy performed in this group of patients could be beneficial. First experiences with implementation of hemicraniectomy in patients with brain infarct in our stroke centre are presented.

Material and methods

Between August 2007 and July 2008, four patients with hemispheric brain infarcts complicated by malignant oedema underwent decompressive hemicraniectomy within 72 hours from symptoms onset. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Clinical outcome was assessed 3, 6 and 12 months after the event using the modified Rankin scale (mRS).

Results

In the first patient, the neurosurgical procedure included only decompressive hemicraniectomy, whereas in the other three duraplasty was performed additionally. The first patient died 23 days after the stroke onset due to acute respiratory failure. Another died at four months after the event, due to infectious complications. The remaining two patients presented severe functional disability 12 months after the procedure (mRS score 4).

Conclusions

Decompressive surgery with duraplasty can be a life-saving procedure for patients with brain oedema. To our knowledge, the presented cases are among the first reported cases of hemispheric ischaemic stroke treated with decompressive hemicraniectomy in Poland. Extended follow-up with a larger group of patients is necessary to assess long-term outcome.

Get Citation

Keywords

decompressive craniectomy, stroke, stroke management, brain oedema

About this article
Title

Decompressive hemicraniectomy in ischaemic stroke

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 44, No 2 (2010)

Pages

131-138

DOI

10.1016/S0028-3843(14)60004-9

Bibliographic record

Neurol Neurochir Pol 2010;44(2):131-138.

Keywords

decompressive craniectomy
stroke
stroke management
brain oedema

Authors

Maciej Świat
Magdalena Targosz-Gajniak
Michał Arkuszewski
Małgorzata Pięta
Jacek Gamrot
Maciej Wojtacha
Piotr Bażowski
Grzegorz Opala

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