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Decompressive craniectomy for arteriovenous malformation-related intracerebral hemorrhage

Satoru Takeuchi1, Yoshio Takasato2, Hiroyuki Masaoka2

  • 1Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|January 8, 2015
PubMed

Insights

Decompressive craniectomy (DC) is a safe treatment for arteriovenous malformation (AVM)-related intracerebral hemorrhage (ICH), showing similar complication rates to hypertensive ICH. Further trials are needed to confirm its efficacy.

Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Arteriovenous malformation (AVM)-related intracerebral hemorrhage (ICH) contributes significantly to morbidity and mortality in AVM patients.
  • Decompressive craniectomy (DC) is a life-saving procedure for elevated intracranial pressure but is less commonly used for AVM-ICH.

Purpose of the Study:

  • To evaluate the safety and outcomes of decompressive craniectomy (DC) in patients with AVM-related intracerebral hemorrhage (ICH).
  • To compare the complication rates of DC for AVM-ICH versus hypertensive ICH.

Main Methods:

  • Retrospective analysis of 12 patients treated with DC for AVM-ICH.
  • Comparison with 23 patients treated with DC for hypertensive ICH.
  • Assessment of patient demographics, hematoma volumes, outcomes, and complications.

Main Results:

  • Outcomes for AVM-ICH patients included good recovery (1), moderate disability (3), severe disability (7), and vegetative state (1).
  • Complications observed: subdural hygroma (4), hydrocephalus (1), intracranial infection (2), and intracranial hemorrhage (1).
  • No significant difference in complication incidence was found between DC for AVM-ICH and hypertensive ICH.

Conclusions:

  • Decompressive craniectomy (DC) appears to have a comparable safety profile for large AVM-ICH as for hypertensive ICH.
  • Further prospective randomized trials are necessary to establish the definitive safety and efficacy of DC for AVM-ICH treatment.

Keywords:
Arteriovenous malformationComplicationDecompressive craniectomyIntracerebral hemorrhageStrokeSurgery

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