Decompressive craniectomy for intractable intracranial hypertension

BAKAR, BULENT; SÜMER, Mehmet Murat; TEKKÖK, İsmail Hakkı

Decompressive craniectomy for intractable intracranial hypertension

BÜLENT BAKAR, (Kırıkkale Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Kırıkkale, Türkiye)

Mehmet Murat SÜMER, (Güven Hastanesi, Nöroloji Kliniği, Ankara, Türkiye)

İsmail Hakkı TEKKÖK (TOBB-ETU Hastanesi, Nöroşirürji Anabilim Dalı, Ankara, Türkiye)

Journal of Clinical and Analytical Medicine

3 1

Yıl: 2012 Cilt: 3 Sayı: 4 Sayfa Aralığı: 383 - 387 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Decompressive craniectomy for intractable intracranial hypertension

Öz:

Amaç: Bu retrospektif klinik çalışmada çeşitli sebeplerle ortaya çıkmış olan intrakranial hipertansiyon tedavisinde dekompresif kraniektominin yeri ve etkileri incelenmiştir. Gereç ve Yöntem: 18 ile 75 yaş arası 9 hasta çalışmaya alınmıştır. Dört hasta travmatik beyin yaralanması, iki hasta subaraknoid kanama ve üç hasta ise malign orta serebral arter tıkanıklığı ile takip ve tedavi edilmiştir. Bulgular: Dokuz hastaya dekompresif kraniektomi tedavisi uygulanmıştır. Bu hastaların ilk başvurularındaki intrakranial basınç (ICP) değerleri ortalaması 22.6 ± 6.7 mmHg; ortalama ameliyat öncesi ICP değeri 40.8 ± 16.3 mmHg ve cerrahi tedavi sonrası ICP ortalama değeri 9.3± 3.6 mmHg olarak ölçülmüştür. İki hastaya bilateral ve kalan yedi hastaya unilateral frontotemporoparietal kraniektomi uygulanmıştır. Kraniektomi kemik flebinin tekrar yerine konması için ortalama 25.75±10.0 gün beklenmiştir. Subaraknoid kanama ile takip edilen bir hasta cerrahi tedavi sonrası ölmüştür (mortalite oranı %11.1). Otuz altı aylık takip sonrası hastaların ortalama Glasgow iyileşme skala puanı yaklaşık 4 olarak hesaplanmıştır. Sonuç: Eğer zamanında ve dikkatli bir şekilde uygulanabilirse bu cerrahi teknik akut ya da gecikmiş dirençli intrakranial hipertansiyon tedavisinde başarılı sonuçlar verir.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Dirençli intrakranial hipertansiyonda dekompresif kraniektomi

Öz:

Aim: This retrospective study was established to analyse the effects of the decompressive craniectomy on patients with different causes of increased intracranial pressure. Material and Method: Nine patients at risk of developing malignant cerebral edema aged between 18 and 75 years were included in this study. Four patients suffered from severe traumatic brain injury, two patients from subarachnoid haemorrhage (SAH) and vasospastic ischemia, and 3 patients from malignant infarction of the middle cerebral artery. Results: Nine patients underwent decompressive craniectomy as the last therapeutic choice. At first admission mean intracranial pressure (ICP) was 22.6 ± 6.7 mmHg; mean preoperative ICP value was 40.8 ± 16.3 mmHg; and mean postoperative ICP value was 9.3± 3.6 mmHg. In two patients bilateral; and in seven patients unilateral frontotemporoparietal craniectomy was preferred. Mean time of the re-implantation of the bone flap was 25.75±10.0 days. One patient with SAH died postoperatively and eight patients survived (mortality rate 11.1%). Mean value of the Glasgow Outcome Scale score as evaluated at 36 months after the decompression was approximately 4. Discussion: This surgical procedure is successful for treatment of the acute or delayed intractable intracerebral hypertension with a low rate of complication if it is performed timely and carefully.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	BAKAR B, SÜMER M, TEKKÖK İ (2012). Decompressive craniectomy for intractable intracranial hypertension. , 383 - 387.
Chicago	BAKAR BULENT,SÜMER Mehmet Murat,TEKKÖK İsmail Hakkı Decompressive craniectomy for intractable intracranial hypertension. (2012): 383 - 387.
MLA	BAKAR BULENT,SÜMER Mehmet Murat,TEKKÖK İsmail Hakkı Decompressive craniectomy for intractable intracranial hypertension. , 2012, ss.383 - 387.
AMA	BAKAR B,SÜMER M,TEKKÖK İ Decompressive craniectomy for intractable intracranial hypertension. . 2012; 383 - 387.
Vancouver	BAKAR B,SÜMER M,TEKKÖK İ Decompressive craniectomy for intractable intracranial hypertension. . 2012; 383 - 387.
IEEE	BAKAR B,SÜMER M,TEKKÖK İ "Decompressive craniectomy for intractable intracranial hypertension." , ss.383 - 387, 2012.
ISNAD	BAKAR, BULENT vd. "Decompressive craniectomy for intractable intracranial hypertension". (2012), 383-387.

APA	BAKAR B, SÜMER M, TEKKÖK İ (2012). Decompressive craniectomy for intractable intracranial hypertension. Journal of Clinical and Analytical Medicine, 3(4), 383 - 387.
Chicago	BAKAR BULENT,SÜMER Mehmet Murat,TEKKÖK İsmail Hakkı Decompressive craniectomy for intractable intracranial hypertension. Journal of Clinical and Analytical Medicine 3, no.4 (2012): 383 - 387.
MLA	BAKAR BULENT,SÜMER Mehmet Murat,TEKKÖK İsmail Hakkı Decompressive craniectomy for intractable intracranial hypertension. Journal of Clinical and Analytical Medicine, vol.3, no.4, 2012, ss.383 - 387.
AMA	BAKAR B,SÜMER M,TEKKÖK İ Decompressive craniectomy for intractable intracranial hypertension. Journal of Clinical and Analytical Medicine. 2012; 3(4): 383 - 387.
Vancouver	BAKAR B,SÜMER M,TEKKÖK İ Decompressive craniectomy for intractable intracranial hypertension. Journal of Clinical and Analytical Medicine. 2012; 3(4): 383 - 387.
IEEE	BAKAR B,SÜMER M,TEKKÖK İ "Decompressive craniectomy for intractable intracranial hypertension." Journal of Clinical and Analytical Medicine, 3, ss.383 - 387, 2012.
ISNAD	BAKAR, BULENT vd. "Decompressive craniectomy for intractable intracranial hypertension". Journal of Clinical and Analytical Medicine 3/4 (2012), 383-387.