| Clinical Outcomes of Decompressive Craniectomy for Malignant Brain Edema after Acute Cerebral Infarction |
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Min-Seok Lee , Yoon-Soo Lee , Jeong-Ho Lee , Kee-Young Ryu , Dong-Gee Kang |
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Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea |
| 급성 뇌경색 후의 중증의 뇌부종에 대한 감압성 두개골 절제술의 치료 성적에 대한 고찰 |
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이민석ㆍ이윤수ㆍ이정호ㆍ류기영ㆍ강동기 |
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대구 파티마병원 신경외과 |
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| Abstract |
Objective
Malignant brain edema is one of the leading causes of death after major cerebral infarction. This study was to evaluate the clinical outcomes and to determine their prognostic factors of decompressive craniectomy for malignant brain edema after acute cerebral infarction, and to access the functional outcomes in elderly patients in comparison with the ones in young patients.
Methods
Between March, 2006 and October, 2010, 37 patients who underwent decompressive craniectomies for malignant brain edema after cerebral infarctions were retrospectively reviewed. According to their modified Rankin Scale (mRS) at least 3 months after the surgery, patients were divided into 2 groups; Group A (mRS=1-4) and Group B (mRS=5-6), and their demographic, clinical and radiological variables were analyzed. According to their ages, the patients were also assigned to another 2 groups; Group I (age<65) and Group II (age≥65), and their clinical variables and functional outcomes were compared.
Results
Old age, involvement of dominant hemisphere, multiple territories, and dilated pupil were statistically significant poor prognostic factors affecting the functional outcomes. Elderly patients had poor functional outcomes regardless of previous medical history although there were no statistically significant differences in mortality rates.
Conclusion
Decompressive craniectomy is a life-saving procedure for malignant brain edema after cerebral infarction, however the prognostic factors must be carefully considered for acceptable functional recovery, especially in elderly patients whose functional outcomes seem to be grave. |
| Key Words:
CraniectomyㆍMalignant brain edemaㆍCerebral infarction |
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