Decompressive Hemicraniectomy for Poor-grade Aneurysmal Subarachnoid Hemorrhage Patients with Associated Intracerebral Hemorrhage: Clinical Outcome and Quality of Life Assessment

D’Ambrosio, Anthony L.; Sughrue, Michael E.; Yorgason, Joshua G.; Mocco, J; Kreiter, Kurt T.; Mayer, Stephan A.; McKhann, Guy M.; Connolly, E. Sander

doi:10.1227/01.neu.0000144820.38439.63

Cited by 101 publications

(90 citation statements)

References 26 publications

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“…В отдель-ных публикациях анализируемые сведения взяты из баз данных ранее проведенных проспективных исследований по поводу аневризматического внутричерепного кровоиз-лияния [14,22]. Контрольная группа (больные без ДТЧ) представлена только в двух исследованиях.…”

Section: анализ публикаций по дтч у больных с внутричерепным кровоизлunclassified

“…D'Ambrosio и соавт. [14] контрольная группа сформи-рована по тем же критериям, что и группа больных с ДТЧ (возраст <75 лет, состояние по шкале Н-Н -IV-V, боль-шая гематома в сильвиевой щели или в височной доле мозга на КТ, клинические признаки компрессии мозга), но операция ДТЧ по каким-либо причинам не выполня-лась. Y. Uozumi и соавт.…”

Section: анализ публикаций по дтч у больных с внутричерепным кровоизлunclassified

“…В 5 работах критерием включения в группу явля-лось наличие большой гематомы в сильвиевой щели или в височной доле мозга как фактора, приводящего к латеральной дислокации мозга и способствующего формированию ишемических очагов в бассейне сред-ней мозговой артерии [11,12,14,18,21]. В других ис-следованиях такие больные составляли отдельные под-группы [6, 13, 15-17, 20, 22, 23].…”

Section: характеристика больных с дтчunclassified

“…В части исследований операции по выключению аневризм из кровотока выполнялись только прямым ми-крохирургическим методом [12,16,18], в другие работы включены больные как с микрохирургическими, так и с эндоваскулярными вмешательствами [14,17,22].…”

Section: характеристика больных с дтчunclassified

“…Некоторые группы включали также больных, которым операции на аневризме не проводи-лись [14]. Помимо операций по выключению аневризм, многим больным устанавливали наружный вентрику-лярный дренаж непосредственно при поступлении или после основной операции.…”

Section: характеристика больных с дтчunclassified

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Decompressive craniotomy in patients with intracranial aneurysmal hemorrhage

et al. 2016

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Section: анализ публикаций по дтч у больных с внутричерепным кровоизлunclassified

Section: характеристика больных с дтчunclassified

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Decompressive craniotomy in patients with intracranial aneurysmal hemorrhage

et al. 2016

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Craniotomy Without Flap Replacement for Ruptured Intracranial Aneurysms to Reduce Ischemic Brain Injury: A Preliminary Safety and Feasibility Analysis

Soleman

Schatlo

Danura

et al. 2014

Acta Neurochirurgica Supplement

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To date, no standardized criteria exist to decide whether the bone flap should be removed or replaced at initial surgery. Our single-center experience in a limited number of patients reveals a pattern with respect to initial clinical parameters and imaging findings that might be a first step in developing standardized decision parameters. This may prevent secondary surgery for decompression in deleterious conditions during the vasospasm phase. Based on these findings, we have developed a protocol for a prospective study that will further investigate the benefits of this management.

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Surgical Management of Aneurysmal Hematomas: Prognostic Factors and Outcome

Meneghelli

Cozzi

Hasanbelliu

et al. 2016

Acta Neurochirurgica Supplement

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From 1991 until 2013, 304 patients with intracranial hematomas from aneurysmal rupture were managed surgically in our department, constituting 17 % of all patients with aneurysmal rupture. Of them, 242 patents presented with isolated intracerebral hematomas (in 69 cases associated with significant intraventricular hemorrhage), 50 patients presented with combined intracerebral and subdural hematomas (in 11 cases associated with significant intraventricular hemorrhage), and 12 presented with an isolated subdural hematoma. The surgical procedure consisted of simultaneous clipping of the aneurysm and evacuation of the hematoma in all cases. After surgery, 16 patients (5 %) submitted to an additional decompressive hemicraniectomy, and 66 patients (21 %) submitted to a ventriculo-peritoneal shunt. Clinical outcomes were assessed at discharge and at 6 months, using the modified Rankin Scale (mRS); a favorable outcome (mRS 0-2) was observed in 10 % of the cases at discharge, increasing to 31 % at 6 months; 6-month mortality was 40 %. Applying uni- and multivariate analysis, the following risk factors were associated with a significantly worse outcome: age >60; preoperative Hunt-Hess grades IV-V; pupillary mydriasis (only on univariate); midline shift >10 mm; hematoma volume >30 cc; and the presence of hemocephalus (i.e., packed intraventricular hemorrhage). Based on these results, an aggressive surgical treatment should be adopted for most cases with aneurysmal hematomas, excluding patients with bilateral mydriasis persisting after rescue therapy.

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Decompressive Hemicraniectomy for Poor-grade Aneurysmal Subarachnoid Hemorrhage Patients with Associated Intracerebral Hemorrhage: Clinical Outcome and Quality of Life Assessment

Cited by 101 publications

References 26 publications

Decompressive craniotomy in patients with intracranial aneurysmal hemorrhage

Decompressive craniotomy in patients with intracranial aneurysmal hemorrhage

Craniotomy Without Flap Replacement for Ruptured Intracranial Aneurysms to Reduce Ischemic Brain Injury: A Preliminary Safety and Feasibility Analysis

Surgical Management of Aneurysmal Hematomas: Prognostic Factors and Outcome

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