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Published on: October 14, 2022
Hydrocephalus after decompressive craniectomy for malignant hemispheric cerebral infarction
Qiang-Ping Wang1,2, Jun-Peng Ma1, Zhang-Ming Zhou2
1a 1 Department of Neurosurgery, West China Hospital, Sichuan University , Chengdu , China.
Insights
Hydrocephalus affects 42.2% of patients after decompressive craniectomy (DC) for malignant cerebral infarction. Lower Glasgow Coma Scale (GCS) scores and subarachnoid hemorrhage (SAH) increase this risk.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Decompressive craniectomy (DC) is used for malignant hemispheric cerebral infarction.
- Post-operative hydrocephalus is a known complication, but its incidence and risk factors require further clarification.
Purpose of the Study:
- To determine the incidence of hydrocephalus after DC for malignant hemispheric cerebral infarction.
- To identify significant risk factors associated with post-operative hydrocephalus.
Main Methods:
- Retrospective cohort study of 128 patients undergoing DC for malignant hemispheric cerebral infarction.
- Analysis of clinical and radiological data using chi-square test, Mann-Whitney U-test, and logistic regression.
Main Results:
- The incidence of ventriculomegaly was 42.2% and shunt-dependent hydrocephalus was 14.8%.
- Lower preoperative Glasgow Coma Scale (GCS) score was significantly associated with hydrocephalus.
- Presence of subarachnoid hemorrhage (SAH) was also a significant risk factor.
Conclusions:
- Patients undergoing DC for cerebral infarction have a moderate risk of post-operative hydrocephalus.
- Poor GCS score and SAH are key predictors for developing hydrocephalus post-DC.
Purpose:
Several studies have investigated the incidence and risk factors of hydrocephalus after decompressive craniectomy (DC) for malignant hemispheric cerebral infarction. However, the results are controversial. Therefore, the following is a retrospective cohort study to determine the incidence and risk factors of hydrocephalus after DC for malignant hemispheric cerebral infarction.
Materials And Methods:
From January 2004 to June 2014, patients at two medical centres in south-west China, who underwent DC for malignant hemispheric cerebral infarction, were included. The patients' clinical and radiologic findings were retrospectively reviewed. A chi-square test, Mann-Whitney U-test and logistic regression model were used to identify the risk factors.
Results:
A total of 128 patients were included in the study. The incidence of ventriculomegaly and shunt-dependent hydrocephalus were 42.2% (54/128) and 14.8% (19/128), respectively. Lower preoperative Glasgow Coma Scale (GCS) score and presence of subarachnoid haemorrhage (SAH) were factors significantly associated with the development of post-operative hydrocephalus after DC.
Conclusions:
Cerebral infarction patients receiving DC have a moderate tendency to suffer from post-operative hydrocephalus. A poor GCS score and the presence of SAH were significantly associated with the development of hydrocephalus after DC.
