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Decompressive Craniectomy for Hemispheric Infarction in a Low-Income Population
Everardo Garcia-Estrada1, Jesús Alberto Morales-Gómez1, Mariana Romero-González1
1Neurosurgery and Neuroendovascular Therapy Department, "Dr. José Eleuterio González" University Hospital, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
World Neurosurgery
|September 13, 2021
Summary
Decompressive craniectomy (DC) for large hemispheric infarction (LHI) in low-income patients showed younger age (<60) correlated with better functional outcomes. Most caregivers would repeat the life-saving stroke surgery.
Area of Science:
- Neurosurgery
- Neurology
- Public Health
Background:
- Stroke is a leading cause of death and disability globally, with higher incidence and severity in disadvantaged populations.
- Large hemispheric infarction (LHI) poses significant challenges for post-stroke care and recovery.
- Decompressive craniectomy (DC) is a surgical intervention for severe brain swelling.
Purpose of the Study:
- To evaluate survival, functional outcomes, and caregiver satisfaction in low-income patients undergoing DC for LHI.
- To identify factors influencing outcomes in this specific patient demographic.
Main Methods:
- Retrospective analysis of 49 adult patients with LHI who underwent DC.
- Data collected included demographics, clinical details, and radiological findings.
- Primary outcomes assessed were 1-year survival and favorable functional outcome.
Main Results:
- Patients younger than 60 years had significantly better functional outcomes (76% vs. 33%) but similar survival rates compared to older patients.
- Time to craniectomy (<48 hours vs. ≥48 hours) did not significantly impact survival or functional outcomes.
- Approximately 79% of caregivers indicated they would opt for the surgery again.
Conclusions:
- Age <60 years was associated with improved functional outcomes after DC for LHI, but not survival.
- The timing of DC relative to stroke onset did not show a statistically significant impact on survival or functional outcomes.
- Caregiver satisfaction remained high, with a majority willing to repeat the procedure regardless of the patient's disability level.
