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01-04-2018 | Original Article

Decompressive craniectomy for intracerebral haematoma: the influence of additional haematoma evacuation

Authors: Alexis Hadjiathanasiou, Patrick Schuss, Inja Ilic, Valeri Borger, Hartmut Vatter, Erdem Güresir

Published in: Neurosurgical Review | Issue 2/2018

Abstract

Intracerebral haemorrhage (ICH) may lead to intractable elevation of intracranial pressure (ICP), which may lead to decompressive craniectomy (DC). In this setting, surgical evacuation of ICH is controversially discussed. We therefore analysed radiological and clinical parameters to investigate the influence of additional haematoma evacuation to DC in patients with ICH. Forty-four patients suffering from spontaneous, hypertensive ICH between August 2007 and February 2016 underwent DC with and without ICH evacuation at the author’s institution. Patients were stratified into two groups (DC without ICH evacuation versus DC with ICH evacuation). Patient characteristics, clinical and radiological findings were assessed and retrospectively analysed. Fifteen (34%) patients underwent DC with additional ICH evacuation and 29 (66%) underwent DC without ICH evacuation. Mean ICH volume was 60 ± 38 ml with no significant difference between both groups (p = 0.8). Midline shift (MLS) reduction after DC did not significantly differ between both groups (p = 0.4). Overall, 13 patients (30%) achieved a favourable outcome. DC can be performed in cases of spontaneous supratentorial ICH and pathological elevated ICP despite best medical treatment. However, additional ICH evacuation does not seem to be beneficial according to the present study and may therefore be omitted.

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Title: Decompressive craniectomy for intracerebral haematoma: the influence of additional haematoma evacuation
Authors: Alexis Hadjiathanasiou
Patrick Schuss
Inja Ilic
Valeri Borger
Hartmut Vatter
Erdem Güresir
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Neurosurgical Review / Issue 2/2018
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-017-0909-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Decompressive craniectomy for intracerebral haematoma: the influence of additional haematoma evacuation

Abstract

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Abstract

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