Decompressive hinge craniectomy with linear durotomies for ischemic stroke: a pilot study

SUMMARY OBJECTIVE: Decompressive craniectomy may be a life-saving measure in ischemic stroke patients, who still have several associated complications. The objective of this study is to evaluate novel decompressive surgery technique for severe hemispheric stroke. METHODS: For the hinge (HDC), linear durotomies were performed. Vertical (one or two frontal and parietal), horizontal (temporal), with approximately 5 cm long, carried out. Duroplasty was performed using an autologous subgaleal tissue graft fixed separate sutures avoid CSF leak direct contact cortex bone flap. flap three parietal locations. We compared 10 patients underwent our modified HDC 9 submitted classical (CDC). primary outcome mortality. RESULTS: Nineteen included, mean age 52.3 years (±8.2). Four (44%) from group had reoperated remove because brain swelling worsening, but none them died. average time 90 minutes. Overall 14-days mortality 21.1% (n=4), cumulative six-months 42.1% (n=8). Five (50%) CDC died, while 3 (33.3%) died (χ2=0.07, p=0.79). length stay 46.7 days (±32.1) 38.7 (±27.1) (p=0.60). CONCLUSIONS: present vertical durotomies, which seems reduced operative craniotomy, although difference not statistically significant.