Size does matter: The role of decompressive craniectomy extent for outcome after aneurysmal subarachnoid hemorrhage

Abstract Background and purpose In previous studies in patients with traumatic brain injury ischemic stroke, the size of decompressive craniectomy (DC) was reported to be paramount regard patient outcomes. We aimed identify impact DC on treatment results individuals aneurysmal subarachnoid hemorrhage (SAH). Methods The extent 232 SAH who underwent bifrontal or hemicraniectomy between January 2003 December 2015 analyzed using semi‐automated surface measurements. study endpoints were course intracranial pressure (ICP) after DC, occurrence cerebral infarcts, in‐hospital mortality, unfavorable outcome at 6 months (defined as modified Rankin scale score >3). associations adjusted for timing, age, clinical radiographic severity SAH, aneurysm location, modality. Results mean area 100.9 (±45.8) cm 2 . multivariate analysis, a large (>105 ) independently associated lower risk infarcts (adjusted odds ratio [aOR] 0.30, 95% confidence interval [CI] 0.16–0.56), mortality (aOR 0.28, CI 0.14–0.56) 0.51, 0.27–0.98). Moreover, small (<75 more likely require prolonged (>3 days, aOR 3.60, 1.37–9.42) enhanced 2.31, 1.12–4.74) postoperative ICP treatment. Conclusion This is first showing control context SAH; specifically, flap might lead better outcomes requiring surgery.