Use of decompressive craniectomy in the treatment of hemispheric infarction

Use of decompressive craniectomy in the treatment of hemispheric infarction

Alternative title Uso da craniectomia descompressiva no tratamento do acidente vascular cerebral isquêmico hemisférico
Author Fiorot Jr., José Antonio Autor UNIFESP Google Scholar
Silva, Gisele Sampaio Autor UNIFESP Google Scholar
Cavalheiro, Sergio Autor UNIFESP Google Scholar
Massaro, Ayrton Roberto Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Centro de Medicina Diagnóstica Fleury
Abstract Decompressive craniectomy (DC) has demonstrated efficacy in reducing mortality in hemispheric infarction of the middle cerebral artery. The aim of our study was to compare the outcome of patients submitted to DC to patients treated in a conservative way. Eighteen patients were submitted to DC and 14 received conservative treatment. Neurological status was assessed by the Glasgow Coma Score and National Institutes of Health Stroke Scale score. Mortality, modified Rankin Scale and Barthel Index scores were assessed at 90 days to evaluate outcome. We did not observe reduction in overall mortality and functional outcome in patients submitted to DC. The differences between our group and previously published series are probably related to the neurological status of the patients at the time of therapeutic decision.

Craniectomia descompressiva (CD) tem demonstrado eficácia em reduzir a mortalidade em pacientes com infarto hemisférico (IH) da artéria cerebral média. Este estudo avaliou o prognóstico dos pacientes submetidos a CD comparando a pacientes com IH tratados de maneira conservadora. Dezoito pacientes foram submetidos a CD e 14 receberam tratamento conservador. Escala de Coma de Glasgow e Escala de AVC do National Institutes of Health foram utilizadas para graduar o déficit neurológico. A mortalidade, bem como os escores obtidos na escala modificada de Rankin e índice de Barthel foram avaliados em 90 dias. Não foi observada redução de mortalidade nos pacientes submetidos a CD. Essa diferença entre os nossos resultados e os estudos publicados previamente se deve, provavelmente, à decisão cirúrgica tardia em pacientes com sinais clínicos de herniação cerebral.
Keywords craniectomy
decompressive surgery
middle cerebral artery infarction
craniectomia
descompressão cirúrgica
infarto da artéria cerebral média
Language English
Date 2008-06-01
Published in Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 66, n. 2a, p. 204-208, 2008.
ISSN 0004-282X (Sherpa/Romeo)
Publisher Academia Brasileira de Neurologia - ABNEURO
Extent 204-208
Origin http://dx.doi.org/10.1590/S0004-282X2008000200012
Access rights Open access Open Access
Type Article
SciELO ID S0004-282X2008000200012 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/4399

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