Ventriculomegaly after decompressive craniectomy with hematoma evacuation for large hemispheric hypertensive intracerebral hemorrhage.
OBJECTIVE
The aim of the present study was to investigate factors associated with the development of ventriculomegaly suggestive of hydrocephalus (VSOH) after decompressive craniectomy with hematoma evacuation for hemispheric hypertensive intracerebral hemorrhage.


METHODS
This study focused on 21 patients who underwent decompressive craniectomy with hematoma evacuation for hemispheric hypertensive intracerebral hemorrhage. The patients' clinical and radiological findings were retrospectively reviewed.


RESULTS
Eleven patients were male and ten were female, with an age range from 22 to 75 years (mean, 56.6 years). The preoperative Glasgow Coma Scale score ranged from 3 to 13 (mean, 6.9). Hematoma volumes ranged from 33.4 to 98.1 ml (mean, 74.2 ml). Hematoma locations were the basal ganglia in 10 patients and the subcortex in 11 patients. The presence of intraventricular hemorrhage was significantly associated with the development of VSOH (P=0.023). The distance of the decompressive defect to the midline and the presence of meningitis showed a strong trend for association with VSOH (P=0.051, P=0.090, respectively).


CONCLUSIONS
Careful attention should be paid to the occurrence of VSOH after decompressive craniectomy with hematoma evacuation in intracerebral hemorrhage patients with intraventricular extension, meningitis, and/or a short distance of the decompressive defect to the midline.
Department of Neurosurgery, National Defense Medical College, Saitama, Japan. s.takeuchi@room.ocn.ne.jp
Satoru
S
Takeuchi
Hiroshi
H
Nawashiro
Kojiro
K
Wada
Yoshio
Y
Takasato
Hiroyuki
H
Masaoka
Takanori
T
Hayakawa
Kimihiro
K
Nagatani
Naoki
N
Otani
Hideo
H
Osada
Katsuji
K
Shima
D000328:Adult; D000368:Aged; D001479:Basal Ganglia / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology*; D019299:Decompression, Surgical / Q000009:adverse effects*; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology; D006984:Hypertrophy / Q000473:pathology; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000473:pathology*; D019586:Intracranial Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult