Decompressive Hemicraniectomy and Duroplasty in Toddlers and Preschool Children with Refractory Intracranial Hypertension after Unilateral Hemispheric Stroke

作者：Lee Sang Kook; Kim Sang Dae^*; Kim Se Hoon; Lim Dong Jun; Park Jung Yul

来源：Journal of Korean Neurosurgical Society, 2012, 51(2): 86-90.

DOI：10.3340/jkns.2012.51.2.86

• Decompressive craniectomy
• Stroke
• Pediatric
• Outcome

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. %26lt;br%26gt;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 %26lt;8 at pre-operation state. The mean time-point of craniectomy after stroke attack was 12 hours (range 4-19). %26lt;br%26gt;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). %26lt;br%26gt;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.

• 出版日期2012-2