Artikel
Primary decompressive hemicraniectomy in poor grade aneurysmal subarachnoid hemorrhage
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Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: Aim of this study was to analyse the effect of primary decompressive hemicraniectomy (pDC) on clinical outcome in patients with poor grade aneurysmal subarachnoid hemorrhage (SAH).
Methods: 61 consecutive poor grade SAH patients were analyzed between 10/2012 and 05/2016. Information including patient characteristics and outcome were prospectively collected in a computerized database. pDC was performed due to clinical signs of herniation or brain swelling according to the treating surgeon. Outcome was analyzed according to modified Rankin Scale (mRS) and dichotomized into favorable (mRS 0-3) and unfavorable outcome (mRS 4-6) after 6 months.
Results: Of 61 patients with poor grade SAH, 32 underwent pDC and 29 did not. Mydriasis was present in 22 patients with and in 8 patients without DC (69 % versus 28 %, p = 0.002), and additional ICH in 66 % vs. 24 % (p = 0.002) respectively. Favorable outcome did not differ between the two groups (22 % versus 21 %).
Conclusion: Despite of a worse clinical status at presentation (significant higher rate of mydriasis and additional ICH), poor grade SAH patients with pDC achieve favorable outcome in a significant number of patients. Therefore treatment and pDC should not be ommited in this severly ill patient collective.