title: Decompressive craniectomy in massive cerebral infarction.
abstract: Twenty one patients were submitted to decompressive craniectomy for massive cerebral infarct. Ten patients (47.6%) presented a good outcome at the 6 months evaluation, eight had a poor outcome (38%) and three died (14.2%). There was no outcome statistical difference between surgery before and after 24 hours of ictus, dominant and non-dominant stroke groups. Patients older than 60 years and those who had a Glasgow Coma Scale (GCS)<8 in the pre-surgical exam presented worst outcome at six months (p<0.05). Decompressive craniectomy for space-occupying large hemispheric infarction increases the probability of survival. Age lower than 60 years, GCS >8 at pre-surgical exam and decompressive craniectomy before signs of brain herniation represent the main factors related to a better outcome. Dominant hemispheric infarction does not represent exclusion criteria.
authors.affiliation: Neurosurgery Department, UNICAMP, Campinas SP, Brazil.
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Mattos
authors.forename: Andrei Fernandes
authors.initials: AF
authors.lastname: Joaquim
authors.forename: João Paulo Cavalcante de
authors.initials: JP
authors.lastname: Almeida
authors.forename: Lucas Alverne Freitas de
authors.initials: LA
authors.lastname: Albuquerque
authors.forename: Elton Gomes da
authors.initials: EG
authors.lastname: Silva
authors.forename: Horácio Armando
authors.initials: HA
authors.lastname: Marenco
authors.forename: Evandro de
authors.initials: Ed
authors.lastname: Oliveira
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000601:surgery*; D056424:Decompressive Craniectomy; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult