TY - JOUR
T1 - Retrospective comparison of craniotomy and decompressive craniectomy for surgical evacuation of nontraumatic, supratentorial intracerebral hemorrhage
AU - Hayes, Seth B.
AU - Benveniste, Ronald J.
AU - Morcos, Jacques J.
AU - Aziz-Sultan, Mohammad A.
AU - Elhammady, Mohamed Samy
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/5
Y1 - 2013/5
N2 - 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.
AB - 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.
KW - Craniotomy
KW - Decompressive craniectomy
KW - Intracerebral hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=84879012744&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879012744&partnerID=8YFLogxK
U2 - 10.3171/2013.2.FOCUS12422
DO - 10.3171/2013.2.FOCUS12422
M3 - Article
C2 - 23634922
AN - SCOPUS:84879012744
VL - 34
JO - Neurosurgical Focus
JF - Neurosurgical Focus
SN - 1092-0684
IS - 5
M1 - E3
ER -