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Characteristics and Outcome in Children With Craniectomy Following Acute Ischemic Stroke in the International

Laura L Lehman1, Gabrielle DeVeber2, Paola Pergami3

  • 11 Department of Neurology, Stroke and Cerebrovascular Center, Boston Children's Hospital, Boston, MA, USA.

Journal of Child Neurology
|July 9, 2019
PubMed

Insights

Craniectomy in children with acute ischemic stroke shows an 8% mortality rate and significant neurological deficits. Further research is needed to understand long-term outcomes in pediatric stroke patients undergoing this procedure.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Stroke Medicine

Background:

  • Hemicraniectomy improves outcomes in adult stroke patients.
  • Pediatric studies on craniectomy for stroke show promising results.
  • Limited data exist on craniectomy for pediatric cerebral sinovenous thrombosis.

Purpose of the Study:

  • To evaluate the outcomes of pediatric patients with acute ischemic stroke treated with craniectomy.
  • To analyze craniectomy outcomes based on stroke location (anterior, posterior circulation) and etiology (cerebral sinovenous thrombosis).

Main Methods:

  • Retrospective analysis of the International Pediatric Stroke Study (IPSS) database.
  • Inclusion criteria: children who underwent craniectomy following ischemic stroke.
  • Data collected on stroke type, location, and patient outcomes.

Main Results:

  • 38 out of 4294 (1%) pediatric stroke patients underwent craniectomy.
  • Craniectomy cases included anterior circulation stroke (29), posterior circulation stroke (5), and cerebral sinovenous thrombosis (4).
  • Mortality rate was 8%; significant neurological deficits were observed in survivors.

Conclusions:

  • Craniectomy in pediatric acute ischemic stroke is associated with significant morbidity and mortality.
  • Outcomes vary by stroke location and type.
  • Prospective studies are essential to determine long-term morbidity after craniectomy in children.

Keywords:
and childhood strokehemicraniectomypediatric strokeposterior decompression

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