Surgical treatment of patients with unilateral cerebellar infarcts: clinical outcome and prognostic factors
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Parmenion P. Tsitsopoulos & Lovisa Tobieson & Per Enblad & Niklas Marklund
- چاپ و سال / کشور: 2011
Description
Background There are limited data on the long-term outcome and on factors influencing the prognosis in patients with cerebellar infarcts treated with surgical decompression. Methods Thirty-two patients (age 64.3پ}9.9 years) with expansive unilateral cerebellar infarcts were retrospectively evaluated. All patients were treated with ventriculostomy, suboccipital decompressive craniectomy and removal of the necrotic tissue. The Glasgow Coma Scale (GCS) and the Reaction Level Scale (RLS) scores evaluated the level of consciousness during hospitalization, while the modified Rankin Scale (mRS) was used for the 6-month and longterm outcome. Predicting factors were analyzed using a univariate logistic regression model. Results The median time from ictus to surgery was 48.4 h (range 8.120 h). Before surgery, the median GCS score was 9 (3.13). At discharge, theGCS score improved to 13.6 (7.15) (p<0.05 compared to preoperative scores). At the long-term follow-up (median 67.5 months), ten patients were dead, and 77% of survivors had a good outcome (mRS score of .2). The number of days on a ventilator and the GCS score prior to surgery and at discharge were strong predictors of clinical outcome (p<0.05), although one third of patients with a GCS. 8 at the time of surgery had a good long-term outcome. In patients .70 years old, 50% had a good long-term outcome, and advanced age was not associated with a bad result (p>0.05). Conclusions Our results imply that surgical evacuation of significant cerebellar infarctions may be considered also in patients with advanced age and/or a decreased level of consciousness.
Acta Neurochir DOI 10.1007/s00701-011-1120-4 Received: 28 March 2011 / Accepted: 27 July 2011
