Decompressive Hemicraniectomy and Duroplasty in Toddlers and Preschool Children with Refractory Intracranial Hypertension after Unilateral Hemispheric Stroke
- Authors
- Lee, Sang-Kook; Kim, Sang-Dae; Kim, Se-Hoon; Lim, Dong-Jun; Park, Jung-Yul
- Issue Date
- 2월-2012
- Publisher
- KOREAN NEUROSURGICAL SOC
- Keywords
- Decompressive craniectomy; Stroke; Pediatric; Outcome
- Citation
- JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, v.51, no.2, pp.86 - 90
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF KOREAN NEUROSURGICAL SOCIETY
- Volume
- 51
- Number
- 2
- Start Page
- 86
- End Page
- 90
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/106125
- DOI
- 10.3340/jkns.2012.51.2.86
- ISSN
- 2005-3711
- 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.
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