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Published on: August 11, 2015
Decompressive hemicraniectomy in large putaminal hematomas: an Indian experience
R Ramnarayan1, Dominic Anto, T V Anilkumar
1Department of Neurosurgery, Dr SMCSI Medical College, Karakonam, India. r_ramnarayan@yahoo.com
Summary
Decompressive hemicraniectomy is a viable surgical option for moderate to large putaminal hematomas, potentially improving patient outcomes. This procedure offers an alternative to medical management for these critical brain bleeds.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Treatment for large putaminal hematomas is primarily medical, with surgical intervention debated.
- Decompressive hemicraniectomy has shown benefits in large hemispheric infarctions, suggesting potential utility in putaminal hematomas.
Purpose of the Study:
- To evaluate the efficacy and outcomes of decompressive craniectomy in patients with moderate to large putaminal hematomas.
Main Methods:
- Analysis of 23 patients with putaminal hematoma who underwent decompressive craniectomy.
- Parameters included clinical presentation, imaging, time to surgery, and Glasgow Outcome Scale at 3 months.
Main Results:
- 13 men and 10 women (ages 31-68) presented with neurological deficits.
- Hematoma size varied; 7 patients had hematomas >5 cm or >60 mL.
- At 3 months, 13 patients had good outcomes, while 10 had poor outcomes (3 deaths).
Conclusions:
- Decompressive hemicraniectomy is a beneficial surgical alternative for moderate to large putaminal hematomas.
- The procedure demonstrated potential for improving outcomes in this patient cohort.
