大脳半球梗塞に対する開頭外減圧術の治療成績と予後

藤本 康倫; 豊田 真吾; 岩本 文徳; 重松 朋芳; 矢野 喜寛; 星 拓; 川口 哲; 太田 富雄; 若山 暁; 吉峰 俊樹

doi:10.2335/scs.37.167

Original Articles

Outcome and Prognosis after Decompressive Hemicraniectomy for Hemispheric Infarction

Yasunori FUJIMOTO ^†, Shingo TOYOTA ^†, Fuminori IWAMOTO ^†, Tomoyoshi SHIGEMATSU ^†, Yoshihiro YANO ^†, Taku HOSHI ^†, Tetsu KAWAGUCHI ^†, Tomio OHTA ^†, Akatsuki WAKAYAMA ^†, Toshiki YOSHIMINE ^†

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Keywords: decompressive hemicraniectomy, hemispheric infarction, long-term outcome

JOURNAL FREE ACCESS

2009 Volume 37 Issue 3 Pages 167-172

DOI https://doi.org/10.2335/scs.37.167

Details

Abstract

We analyzed 22 patients with hemispheric infarction that underwent decompressive hemicraniectomy with duroplasty (DHCD) between October 2003 and September 2007. The surgery was indicated when the level of consciousness deteriorated, anisocoria appeared, or the midline shift on computed tomography worsened. These patients comprised 14 males and 10 females aged 58 to 90 years old (mean 71.5 years old). At 6 months follow-up, 6 cases (27%) had a good outcome (Barthel Index (BI)≥15), and 16 cases (73%) had a poor outcome (BI<15). The mortality rate was 31.8% (7 cases), and 3 patients (13.6%) died of cerebral herniation. The results showed that DHCD can effectively control intractable intracranial hypertension due to hemispheric infarction, even in elderly patients.

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