Decompressive Hemicraniectomy and Duroplasty in Toddlers and Preschool Children with Refractory Intracranial Hypertension after Unilateral Hemispheric Stroke
Journal of Korean Neurosurgical Society
;
: 86-90, 2012.
Artigo
em Inglês
| WPRIM
| ID: wpr-9390
ABSTRACT
OBJECTIVE:
Life-threatening hemispheric stroke is associated with a high mortality and morbidity. Decompressive hemicraniectomy has been regarded as an effective treatment option for refractory intracranial hypertension. Here, we reported the clinical course of 5 children with decompressive craniectomy and duroplasty after non-traumatic refractory intracranial hypertension.METHODS:
Four toddlers and one preschool-girl were included in this study; there were 3 boys and 2 girls with a mean age of 34.6 months (range 17-80). Decompressive craniectomy including duroplasty was performed in cases of dilatation of pupil size after intensified standard medical therapy had proven insufficient. All children had a Pediatric Glasgow Coma Scale score <8 at pre-operation state. The mean time-point of craniectomy after stroke attack was 12 hours (range 4-19).RESULTS:
During the long-term follow-up period (mean 47.6 months), no children died. One year later, when we checked their Glasgow Outcome Scale scores, only one toddler received a score of 4 (moderate disability). But the others had good recoveries although they had minor physical or mental deficits. According to the Pediatric Cerebral Performance Category Scale, 4 children received a score of 2 (mild disability).CONCLUSION:
Despite our small cases, we suggest that decompressive hemicraniectomy and duroplasty is an acceptable and life-saving treatment for refractory intracranial hypertension after unilateral hemispheric stroke in toddlers and preschool children.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Escala de Coma de Glasgow
/
Pupila
/
Seguimentos
/
Hipertensão Intracraniana
/
Acidente Vascular Cerebral
/
Escala de Resultado de Glasgow
/
Dilatação
/
Craniectomia Descompressiva
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Criança
/
Criança, pré-escolar
/
Humanos
Idioma:
Inglês
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2012
Tipo de documento:
Artigo
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