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Related Experiment Video

Updated: Jun 11, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Decompressive craniectomy in massive cerebral infarction.

João Paulo Mattos1, Andrei Fernandes Joaquim, João Paulo Cavalcante de Almeida

  • 1Neurosurgery Department, UNICAMP, Campinas SP, Brazil.

Arquivos De Neuro-Psiquiatria
|July 6, 2010
PubMed
Summary

Decompressive craniectomy improves survival for massive cerebral infarct. Younger patients, higher Glasgow Coma Scale scores, and early surgery predict better outcomes in stroke patients.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Massive cerebral infarction poses significant mortality risks.
  • Decompressive craniectomy is a surgical option for managing increased intracranial pressure.

Purpose of the Study:

  • To evaluate the outcomes of decompressive craniectomy in patients with massive cerebral infarction.
  • To identify factors influencing patient outcomes after this procedure.

Main Methods:

  • Retrospective analysis of 21 patients undergoing decompressive craniectomy for massive cerebral infarction.
  • Assessment of outcomes at 6 months, including Glasgow Coma Scale (GCS) scores and survival rates.

Main Results:

  • Overall, 47.6% had good outcomes, 38% had poor outcomes, and 14.2% died at 6 months.

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  • Age over 60 and pre-surgical GCS < 8 were associated with significantly worse outcomes (p<0.05).
  • No significant difference in outcomes was found based on timing of surgery (before/after 24 hours) or stroke dominance.

    • Conclusions:

    • Decompressive craniectomy increases survival probability in massive hemispheric infarction.
    • Favorable outcomes are linked to younger age (<60 years), higher pre-surgical GCS (>8), and early intervention before herniation.
    • Dominant hemispheric infarction should not be an exclusion criterion for surgery.