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Journal of Korean Neurosurgical Society > Volume 20(10-11); 1991 > Article
Journal of Korean Neurosurgical Society 1991;20(10-11): 854-859.
Decompressive Craniectomy for Acute Cerebral Infarction.
Heung Sun Lee, Won Han Shin, Soon Kwan Choi, Bark Jang Byun, In Soo Lee
1Departments of Neurosurgery, College of Medicine, Soonchunhyang University, Seoul, Korea.
2Departments of Neurosurgery, Daejeon Rehabilitation Hospital, Korea.
We present a series of 10 Patients(Seven men and three women with an average age of 53 years) who underwent decompressive craniectomy for treatment to massive brain swelling following acute cerebral infarction. Clinical signs of cerebral herniation(anisocoria or fixed and dilated pupil, and/or hemiplegia with decerebrate righidity) were present in all patients. Computed tomography and magnetic resonance imaging showed the mass effect by cerebral edema through midline shift. All patients were treated with an extensive craniectomy and duroplasty. Among them, one recovered without neurological deficit, three were moderately disabled but functionally dependent, three remained in a persistent vegetative state and three died within 9 days after surgery(good recovery=1, moderate disability=3, persistent vegetative state=3, death=3). The results suggest that decompressive craniectomy can be an useful lifesaving procedure for massive cerebral edema following widespread hemispheric infarction.
Key Words: Cerebral infarction; Brain edema; Brain swelling; Decompressive craniectomy; Prognosis
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