The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage

Introduction Spontaneous intracerebral hemorrhage (SICH) is one of the most devastating forms of stroke with a mortality of 30 to 40%. We aimed to evaluate the effect of craniotomy size and volume of decompression on surgical outcome, complications, mortality, and morbidity in patients with supraten...

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Autores principales:	Sashanka Kode, Ajay Hegde, Girish R. Menon
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical Publishers, Inc. 2021
Materias:	decompressive craniectomy spontaneous intracerebral hemorrhage stroke mrs surgical outcome Surgery RD1-811 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/8873ae08c5044909bdff4f03449e44ad
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spelling	oai:doaj.org-article:8873ae08c5044909bdff4f03449e44ad2021-11-25T01:45:58ZThe Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage2277-954X2277-916710.1055/s-0041-1730102https://doaj.org/article/8873ae08c5044909bdff4f03449e44ad2021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1730102https://doaj.org/toc/2277-954Xhttps://doaj.org/toc/2277-9167Introduction Spontaneous intracerebral hemorrhage (SICH) is one of the most devastating forms of stroke with a mortality of 30 to 40%. We aimed to evaluate the effect of craniotomy size and volume of decompression on surgical outcome, complications, mortality, and morbidity in patients with supratentorial capsuloganglionic bleeds who underwent a decompressive craniectomy (DC) at our institute. Materials and Methods It is a retrospective study done between January 2015 and December 2019. All patients with capsuloganglionic bleeds who had DC and hematoma evacuation were included in the study. Results A total of 55 patients underwent DC for SICH at our hospital during the study period. Mean anteroposterior (AP) diameter of the bone flap was 12.42 cm. The volume of decompression did not influence mortality and morbidity in our study but a larger AP diameter was associated with a higher incidence of hydrocephalus. A smaller craniectomy with an AP diameter of < 12 cm caused a lesser reduction in midline shift (MLS). Persistent postoperative MLS had a significant impact on mortality and its reduction was dependent on the size of craniectomy (p =–0.037) Conclusion DC with a recommended AP diameter of 12 to 13 cm achieves optimal results in terms of reduction in MLS. Larger DC volume carries a higher risk of hydrocephalus and requires close follow-up.Sashanka KodeAjay HegdeGirish R. MenonThieme Medical Publishers, Inc.articledecompressive craniectomyspontaneous intracerebral hemorrhagestrokemrssurgical outcomeSurgeryRD1-811Neurology. Diseases of the nervous systemRC346-429ENIndian Journal of Neurosurgery (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	decompressive craniectomy spontaneous intracerebral hemorrhage stroke mrs surgical outcome Surgery RD1-811 Neurology. Diseases of the nervous system RC346-429
spellingShingle	decompressive craniectomy spontaneous intracerebral hemorrhage stroke mrs surgical outcome Surgery RD1-811 Neurology. Diseases of the nervous system RC346-429 Sashanka Kode Ajay Hegde Girish R. Menon The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage
description	Introduction Spontaneous intracerebral hemorrhage (SICH) is one of the most devastating forms of stroke with a mortality of 30 to 40%. We aimed to evaluate the effect of craniotomy size and volume of decompression on surgical outcome, complications, mortality, and morbidity in patients with supratentorial capsuloganglionic bleeds who underwent a decompressive craniectomy (DC) at our institute. Materials and Methods It is a retrospective study done between January 2015 and December 2019. All patients with capsuloganglionic bleeds who had DC and hematoma evacuation were included in the study. Results A total of 55 patients underwent DC for SICH at our hospital during the study period. Mean anteroposterior (AP) diameter of the bone flap was 12.42 cm. The volume of decompression did not influence mortality and morbidity in our study but a larger AP diameter was associated with a higher incidence of hydrocephalus. A smaller craniectomy with an AP diameter of < 12 cm caused a lesser reduction in midline shift (MLS). Persistent postoperative MLS had a significant impact on mortality and its reduction was dependent on the size of craniectomy (p =–0.037) Conclusion DC with a recommended AP diameter of 12 to 13 cm achieves optimal results in terms of reduction in MLS. Larger DC volume carries a higher risk of hydrocephalus and requires close follow-up.
format	article
author	Sashanka Kode Ajay Hegde Girish R. Menon
author_facet	Sashanka Kode Ajay Hegde Girish R. Menon
author_sort	Sashanka Kode
title	The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage
title_short	The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage
title_full	The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage
title_fullStr	The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage
title_full_unstemmed	The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage
title_sort	effect of size of decompressive craniectomy on outcome in deep spontaneous intracerebral hemorrhage
publisher	Thieme Medical Publishers, Inc.
publishDate	2021
url	https://doaj.org/article/8873ae08c5044909bdff4f03449e44ad
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The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage

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