THE EFFICACY OF DECOMPRESSIVE CRANIECTOMY IN TREATMENT OF PATIENTS WITH MASSIVE HEMISPHERIC CEREBRAL INFARCTION

Massive cerebral infarction is often accompanied by early death, secondary to brain edema and trans-tentorial herniation. Several reports indicate beneficial effects of decompressive craniectomy in this situation, but the efficacy of this procedure is still a matter of debate. A n experimental study in a period of3 years was done on2 3 patients with brain edema due to massive cerebral infarction 11 patients were subjects and were operated, and1 2 were in the non-operated group who only underwent conservative treatment. A ll patients in this study had GCS below 8. The m ean age of the operated patients was 54.5 yea r s and f o r the unoperated patients 64.4 yea r s. Mean GCS in the operated cases was 7.00 and in the unoperated cases was 7.66. In the operated g r o up 4 of 11 patient s lived (36.4%) and in the u l10perated group1 o f1 2 cases lived ( 8.3%). I n the living operated cases, 1 had GOS 4 and 3 cases had GOS 3. In unoperated cases 1 patient lived that had a GOS of2. These results show that decompressive craniectomy can be an effective lifesaving procedure for malignant brain edema after cerebral infarction and can also give acceptable functional recovery.