title: Retrospective comparison of craniotomy and decompressive craniectomy for surgical evacuation of nontraumatic, supratentorial intracerebral hemorrhage.
abstract: Surgical evacuation of nontraumatic, supratentorial intracerebral hemorrhage (SICH) is uncommonly performed, and outcomes are generally poor. On the basis of published experimental data and the authors' anecdotal observations, a retrospective chart review study was performed to test the hypothesis that large decompressive craniectomies (DCs), compared with craniotomies, would improve clinical outcomes after surgical evacuation of SICH. For patients with putaminal SICH, DC was associated with a statistically significant improvement in midline shift, compared with craniotomy. Decompressive craniectomies also resulted in a strong trend toward decreased likelihood of poor neurological outcome (modified Rankin Scale score > 3). For patients with lobar SICH, no associations were found between DC or craniotomy and clinical outcomes. For patients selected to undergo surgical evacuation of putaminal SICH, a DC in addition to surgical evacuation of the hematoma might improve outcome.
authors: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
authors: Seth B
authors: SB
authors: Hayes
authors: Ronald J
authors: RJ
authors: Benveniste
authors: Jacques J
authors: JJ
authors: Morcos
authors: Mohammad A
authors: MA
authors: Aziz-Sultan
authors: Mohamed Samy
authors: MS
authors: Elhammady
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome