title: Decompressive craniectomy in patients with cerebral infarction due to malignant vasospasm after aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  The authors present their experience and the clinical results in decompressive craniectomy (DC) in patients with vasospasm after aneurysmal subarachnoid hemorrhage (SAH).
  
  
  METHODS
  Between 2002 and 2010, six patients underwent DC due to cerebral infarct and edema secondary to vasospasm after aneurysmal SAH. Four patients were male, and two were female. The age of patients ranged between 33 and 60 (mean: 47,6 ± 11,4). The follow up period ranged between 12 to 104 months (mean: 47,6 ± 36,6). The SAH grading according World Federation of Neurosurgeons (WFNS) score ranged between 3 to 5.
  
  
  RESULTS
  Last documented modified Rankin Score (mRS) ranged between 2 to 6. One patient died in the following year after decompression due to pneumonia and sepsis. Two patients had moderate disability (mRS of 4) and three patients continue their life with minimal deficit and no major dependency (mRS score 2 and 3).
  
  
  CONCLUSIONS
  DC can be a life-saving procedure which provides a better outcome in patients with cerebral infarction secondary to vasospasm and SAH. However, the small number of the patients in this study is the main limitation of the accuracy of the results, and more studies with larger numbers are required to evaluate the efficiency of DC in this group of patients.
authors.affiliation: Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Saffet
authors.initials: S
authors.lastname: Tuzgen
authors.forename: Baris
authors.initials: B
authors.lastname: Kucukyuruk
authors.forename: Seckin
authors.initials: S
authors.lastname: Aydin
authors.forename: Fatma
authors.initials: F
authors.lastname: Ozlen
authors.forename: Osman
authors.initials: O
authors.lastname: Kizilkilic
authors.forename: Bashar
authors.initials: B
authors.lastname: Abuzayed