Effectiveness of Decompressive Suboccipital Craniectomy for Cerebellar Infarction

Yoshio Suyama, Shinichi Wakabayashi, Hiroshi Aihara, Yusuke Ebiko, Hiroshi Kajikawa and Ichiro Nakahara

Department of Neurosurgery, Suiseikai Kajikawa Hospital, Japan
Department of Comprehensive Strokology, Fujita Health University School of Medicine, Japan

^*Correspondance to: Ichiro Nakahara 

 PDF  Full Text DOI: 10.25107/2474-1647.2019

Abstract

Objective: The adaptation of surgical treatments for cerebellar infarction that have occupied lesions remains subject to discussion. We investigated effectiveness of Decompressive Suboccipital Craniectomy (DSC) for cerebellar infarction and poor prognostic factors affecting surgical results.Materials and
Methods: From October 2006 to June 2017, 14 consecutive patients (12 males, 2 females; age, 42–84 years; mean age ± standard deviation, 65 ± 12 years) admitted to our hospital and underwent DSC under at an admission or clinical course in hospitalization following inclusion criteria: 1) level of consciousness below Glasgow Coma Scale (GCS) 13 or 2) brainstem compression and/or obstructive hydrocephalus due to brain edema by cerebellar infarction. Ventricular drainage was performed simultaneously or later by surgeons’ decision.Results: After 90 days, 12 of the 14 patients survived (85.7%), 10 (71.4%) were independent (modified Rankin scale [mRS] ≤ 2) and four (28.6%) were completely dependent or dead. Comparison between good and poor prognosis demonstrated that the factors affecting prognosis were lesions other than cerebellar infarction (p<0.01) and obstructive hydrocephalus (p<0.05).Conclusion: Early DSC for cerebellar infarction may be advisable for cerebellar infarction in patients with GCS 13 or worse before advancement of hydrocephalus. Poor prognosis is inevitable in patients causing otherinfarcts other than cerebellum and patients who have already accompanied obstructive hydrocephalus at the time of surgery.

Keywords

Cerebellar infarction; Decompressive suboccipital Craniectomy; Ventricular drainage; Outcome

Cite the article

Suyama Y, Wakabayashi S, Aihara H, Ebiko Y, Kajikawa H, Nakahara I. Effectiveness of Decompressive Suboccipital Craniectomy for Cerebellar Infarction. Clin Surg. 2018; 3: 2019.