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Retrospective comparison of craniotomy and decompressive craniectomy for surgical evacuation of nontraumatic, supratentorial intracerebral hemorrhage.

Authors
  • Hayes, Seth B
  • Benveniste, Ronald J
  • Morcos, Jacques J
  • Aziz-Sultan, Mohammad A
  • Elhammady, Mohamed Samy
Type
Published Article
Journal
Neurosurgical focus
Publication Date
May 01, 2013
Volume
34
Issue
5
Identifiers
DOI: 10.3171/2013.2.FOCUS12422
PMID: 23634922
Source
Medline
License
Unknown

Abstract

Surgical evacuation of nontraumatic, supratentorial intracerebral hemorrhage (SICH) is uncommonly performed, and outcomes are generally poor. On the basis of published experimental data and the authors' anecdotal observations, a retrospective chart review study was performed to test the hypothesis that large decompressive craniectomies (DCs), compared with craniotomies, would improve clinical outcomes after surgical evacuation of SICH. For patients with putaminal SICH, DC was associated with a statistically significant improvement in midline shift, compared with craniotomy. Decompressive craniectomies also resulted in a strong trend toward decreased likelihood of poor neurological outcome (modified Rankin Scale score > 3). For patients with lobar SICH, no associations were found between DC or craniotomy and clinical outcomes. For patients selected to undergo surgical evacuation of putaminal SICH, a DC in addition to surgical evacuation of the hematoma might improve outcome.

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