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

Seth B. Hayes, Ronald J. Benveniste, Jacques J. Morcos, Mohammad Ali Aziz-Sultan, Mohamed Samy Elhammady

Research output: Contribution to journalArticle

28 Scopus citations

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.

Original languageEnglish (US)
Article numberE3
JournalNeurosurgical focus
Volume34
Issue number5
DOIs
StatePublished - May 1 2013

Keywords

  • Craniotomy
  • Decompressive craniectomy
  • Intracerebral hemorrhage

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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