Decompressive hemicraniectomy and duroplasty in toddlers and preschool children with refractory intracranial hypertension after unilateral hemispheric stroke

Sang Kook Lee, Sang Dae Kim, Se Hoon Kim, Dong Jun Lim, Jung Yul Park

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)86-90
Number of pages5
JournalJournal of Korean Neurosurgical Society
Volume51
Issue number2
DOIs
Publication statusPublished - 2012

Keywords

  • Decompressive craniectomy
  • Outcome
  • Pediatric
  • Stroke

ASJC Scopus subject areas

  • Surgery
  • Neuroscience(all)
  • Clinical Neurology

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