| Clinical Outcomes of Hemorrhagic Large Territory Infarction in Elderly Patients Over 65 Years Old |
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Sung Soo Bae , Hee Sup Shin , Hyuk Jai Choi , Seok Keun Choi , Tae Sung Kim , Bong Arm Rhee , Young Jin Lim |
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Department of Neurosurgery, Kyung Hee University School of Medicine, Seoul, Korea |
| 출혈성 뇌경색이 동반된 65세 이상 고령 환자의 임상 분석 |
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배성수ㆍ신희섭ㆍ최혁재ㆍ최석근ㆍ김태성ㆍ이봉암ㆍ임영진 |
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경희대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
Decompressive craniectomy is considered as life saving treatment about malignant large territory cerebral infarction. Most published literatures about outcomes of decompressive craniectomy are based on studies performed in patients who are under age of 60. We evaluatedclini cal outcomes and modality of decompressive craniectomy for hemorrhagic infarction in elderly patients (≥65 years old) with review of the literatures.
Methods
We analyzed 42 patients who underwent decompressive craniectomy for large territory cerebral infarction from 2008 to 2010. The cutoff point for age of ≥65 years was set, and the patients separated to hemorrhagic infarction and non-hemorrhagic infarction. Comparisons between two groups were made within several factors. Mortality rates and outcome were assessed by modified Rankin scale (mRS).
Results
The postoperative mRS was 4.08 for hemorrhagic infarction group. We achieved favorable outcomes (mRS ≤3) in 6 patients. Nonhemorrhagic infarction group presented postoperative mRS was 4.27 and 6 favorable outcomes in 17 hemorrhagic infarction patients. In hemorrhagic infarction group, postoperative hemorrhagic transformation patients has more favorable outcomes than preoperative hemorrhagic transformation patients (p-value=0.002).
Conclusion
Decompressive craniectomy for hemorrhagic large territory infarction in elderly patients (>65 years old) in our study showed acceptable outcomes compared with previous literature. However, because here are many factors which could influence the outcome, postoperative medical treatments should be performed appropriately. |
| Key Words:
Large territory infarctionㆍDecompressive craniectomyㆍHemorrhagic infarction |
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