Background: Spontaneous intracerebral hemorrhage (ICH) is one of the most devastating forms of cerebrovascular disease and is associated with high mortality and morbidity rate. Mass-effects of hematoma and surrounding edema lead to increase intracranial pressure and subsequent brain herniation. Decompressive craniectomy(DC) provide space for the edematous brain to expand away from the midline structures and reduce intracranial pressure. Aim of the study :the aim of this study was to evaluate the outcome of Outcomes of Decompressive Craniectomy for Spontaneous Deep Supratentorial Intracerebral Hemorrhage Patient and Methods: We retrospectively reviewed the medical records of the patients with spontaneous deep supratentorial ICH who underwent DC without evacuation of hematoma within 24 hour of ictus. Outcome was assessed by the Glasgow outcome scale (GOS) 6 months after surgery. Results: A total of 12 patients were included in this study. The mean age was 45 years. Mean preoperative Glasgow Coma Scale (GCS) score was 6.7. Mean hematoma volume was 68 ml. At 6 months after surgery, 8 patients (67%) had favorable outcome while 4(33%) had unfavorable outcome, 2 patients (17%) died. 83% of patients with preoperative GCS score 8-9 compared to 50% with preoperative GCS score 5-7 had favorable outcome. 71% of patients with hematoma volume less than or equal to 70ml compared with 60% with hematoma volume more than 70ml had favorable outcome. Conclusions: Decompressive craniectomy can be beneficial in treatment of spontaneous deep supratentorial ICH in selected patient group. Patients with high preoperative GCS score and small hematoma volume are more likely to have favorable outcome. |
