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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Decompressive craniectomy for vasospasm related infarction following aneurysmal subarachnoid hemorrhage: the influence of the size of infarction

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  • Simon Brandecker - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Alexis Hadjiathanasiou - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Tamara Yasmin Kern - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocP134

doi: 10.3205/18dgnc475, urn:nbn:de:0183-18dgnc4758

Veröffentlicht: 18. Juni 2018

© 2018 Brandecker et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Aim of this study was to analyze the effect of decompressive craniectomy (DC) on clinical outcome in patients with vasospasm related infarction following aneurysmal subarachnoid hemorrhage (aSAH) – regarding the influence of the size of infarction.

Methods: Between 01/2011 and 01/2017 24 patients with aSAH and vasospasm related infarctions underwent a decompressive craniectomy at our institution. Information including patient characteristics and outcome were prospectively collected in a computerized database.

The size of infarction was measured by 19 segments, in which the territories of the major cerebral arteries were divided into. Outcome was analysed according to modified Rankin Scale (mRS) and dichotomized into favourable (mRS 0-3) and unfavourable outcome (mRS 4-6) after 6 months.

Results: Overall, a favourable outcome was achieved in 5 of 24 patients (21%). In patients with infarction of 1 large vessel territory favourable outcome was achieved in 4 of 9 patients (44%) and in 1 of 15 patients (7%) with infarction of >1 large vessel territory (p=0.047).

In patients with infarction of ≤2 segments favourable outcome was achieved in 4 of 7 patients (57%) and in 1 of 17 patients (6%) with infarction of >2 segments (p=0.014).

Conclusion: Our data indicates that a significant number of patients undergoing decompressive craniectomy for vasospasm related infarction after aSAH can achieve favourable outcome. The subgroups of patients with infarction in only 1 large vessel territory or ≤2 segments seem to have the most benefit. Careful decision making is needed in each individual case.