gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Benefit of decompressive craniectomies in life threatening intracranial hypertension: A prospective study of 200 patients

Nutzen der Dekompressionsoperation bei lebensbedrohlicher intrakranieller Hypertension: eine prospektive Studie über 200 Patienten

Meeting Abstract

  • corresponding author Dieter H. Woischneck - Klinik für Neurochirurgie, Otto-von-Guericke Universität, Magdeburg
  • J. Wagener - Klinik für Neurochirurgie, Otto-von-Guericke Universität, Magdeburg
  • I. Peters - Klinik für Biometrie und medizinische Statistik, Otto-von-Guericke Universität, Magdeburg
  • C. Grimm - Klinik für Neurochirurgie, Otto-von-Guericke Universität, Magdeburg
  • R. Firsching - Klinik für Neurochirurgie, Otto-von-Guericke Universität, Magdeburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.14.05

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0138.shtml

Published: April 23, 2004

© 2004 Woischneck et al.
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Outline

Text

Objective

The benefit from decompressive craniectomies is discussed controversially. The study compares indications and results of the operation in different pathologies, leading to life threatening intracranial hypertension.

Methods

We report prospective data from 200 patients with progressive deterioration or coma, leading to decompressive craniectomy (brain injury (BI), n=100; spontaneous intracranial bleeding (ICB), n=56, supratentorial infarctions (SI), n=40; edema after tumor resection, n=4).

Results

With bilaterally fixed pupils preoperatively, a favourable outcome was noticed after BI (15%), ICB (8%) and tumor edema (2%), but never after SI. With anisocoria preoperatively, unfavourable outcome was statistically more frequent in patients after SI. After BI and ICB, favourable outcome was noticed in coma, combined with pupillary disturbances for more than 3 hours, but not in SI. Cerebral vasospasm lead to unfavourable outcome in ICB, inspite of craniectomy was performed.

Conclusions

As some patients with bilaterally fixed pupils survived after DC, there is no doubt that DC is helpful in certain instances.