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Decompressive craniectomy in patients with cerebral infarction due to malignant vasospasm after aneurysmal

Saffet Tuzgen1, Baris Kucukyuruk, Seckin Aydin

  • 1Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

Journal of Neurosciences in Rural Practice
|November 29, 2012
PubMed

Insights

Decompressive craniectomy (DC) may be life-saving for patients experiencing cerebral infarction due to vasospasm following aneurysmal subarachnoid hemorrhage (SAH). This procedure can lead to better outcomes, though larger studies are needed.

Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Aneurysmal subarachnoid hemorrhage (SAH) can lead to severe neurological complications, including cerebral infarction and edema due to vasospasm.
  • Decompressive craniectomy (DC) is a surgical intervention aimed at reducing intracranial pressure and improving cerebral perfusion.

Purpose of the Study:

  • To evaluate the clinical outcomes of decompressive craniectomy (DC) in patients suffering from cerebral infarct and edema secondary to vasospasm after aneurysmal subarachnoid hemorrhage (SAH).

Main Methods:

  • A retrospective analysis of six patients who underwent DC between 2002 and 2010 for vasospasm-induced complications post-SAH.
  • Patient demographics, SAH severity (World Federation of Neurosurgeons score), and follow-up data including modified Rankin Scale (mRS) scores were collected.

Main Results:

  • Outcomes varied, with one patient mortality (pneumonia, sepsis) and two patients experiencing moderate disability (mRS 4).
  • Three patients achieved favorable outcomes with minimal deficit (mRS 2-3), indicating potential benefit from DC.

Conclusions:

  • Decompressive craniectomy (DC) appears to be a potentially life-saving procedure for managing cerebral infarction secondary to vasospasm in SAH patients.
  • The small sample size limits definitive conclusions, highlighting the need for larger, prospective studies to confirm the efficacy of DC in this patient population.
Abstract

Keywords:
Cerebral infarctiondecompressive craniectomysubarachnoid hemorrhagevasospasm

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