FUNCTIONAL RECOVERY AFTER DECOMPRESSIVE CRANIECTOMY FOR CEREBRAL INFARCTION
FUNCTIONAL RECOVERY AFTER DECOMPRESSIVE CRANIECTOMY FOR CEREBRAL INFARCTION
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DOI：
10.1227/00006123-198808000-00002
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发表时间：
1988-08-01
期刊：
影响因子：
4.8
通讯作者：
FAZL, M
中科院分区：
文献类型：
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作者：
KONDZIOLKA, D;FAZL, M
对于去骨瓣减压术在治疗引起颅内压增高和脑水肿的病变中的益处，一直存在争议。实验室工作显示颅骨切除术后颅内压降低，但潜在脑水肿形成的矛盾增强，这可能对患者不利。自从Rengachary等人提倡大面积脑梗死的颅骨切除术并报告了他们的3例患者组以来，我们已经治疗了5例急性幕上脑梗死患者，这些患者进展为钩回疝，并因ICP升高和脑干压迫而濒临死亡。所有患者均在常规药物治疗无效后接受额颞部颅骨切除术治疗。所有患者均存活，并能行走，尽管出现了与其原始中风相适应的轻瘫。两个人回到了工作岗位。脑梗塞后幕上颅骨切除术的良好结果表明，该手术可以挽救生命，也可以提供可接受的功能恢复。
There is continuing controversy about the benefits of decompressive craniectomy in the treatment of lesions causing increased intracranial pressure (ICP) and brain edema. Laboratory work has shown a decrease in ICP after craniectomy, but also a paradoxical enhancement in the formation of underlying cerebral edema, which may act to the detriment of the patient. Since Rengachary et al. advocated craniectomy for massive cerebral infarction and reported their group of three patients, we have managed five patients with acute supratentorial cerebral infarction who progressive to uncal herniation and impending death from raised ICP and brain stem compression. All were treated with frontotemporal craniectomy after conventional medical therapy failed to achieve a response. All patients survived and are walking, despite a paresis appropriate to their original stroke. Two have returned to work. Good results with supratentorial craniectomy after infarction show that this procedure is life-saving and can also give acceptable functional recovery.