Decompressive hemicraniectomy in children with severe ischemic stroke and life-threatening cerebral edema.
Decompressive hemicraniectomy has been discussed as a treatment option that increases survival in adults with malignant stroke. This approach has not been studied extensively in children. From a prospective cohort, we identified 4 children who underwent decompressive hemicraniectomy for malignant infarctions with life-threatening cerebral edema within 72 hours of their stroke. All 4 children had different causes for their stroke and experienced severe cerebral edema with increasing intracranial pressure and an impending fatal outcome. Despite massive cerebral infarction, all patients were ambulant and able to speak at the time of follow-up. Although a limited experience, decompressive hemicraniectomy is a life-saving approach for malignant stroke in children.
Ramaswamy
Vijay
V
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Mehta
Vivek
V
Bauman
Mary
M
Richer
Lawrence
L
Massicotte
Patti
P
Yager
Jerome Y
JY
D000293:Adolescent; D001925:Brain Damage, Chronic / Q000175:diagnosis; D001929:Brain Edema / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003399:Craniotomy; D019299:Decompression, Surgical; D038524:Diffusion Magnetic Resonance Imaging; D005500:Follow-Up Studies; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000175:diagnosis / Q000601:surgery; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000601:surgery*; D015278:Intensive Care Units, Pediatric; D008297:Male; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed