BACKGROUND AND PURPOSE: Thirteen percent of patients with cerebral venous and sinus thrombosis (CVST) has a poor clinical outcome. In patients with a poor prognosis, endovascular thrombolysis can be considered, but this procedure does not appear to be beneficial in patients with impending transtentorial herniation because of large hemorrhagic venous infarcts. Therefore, halfway through 2006, we changed our policy to decompressive hemicraniectomy in these patients. METHODS: Patients with CVST and impending herniation attributable to venous infarcts were eligible for surgical intervention. Since 2006 we consecutively treated 3 patients with decompressive hemicraniectomy. Two patients had an excellent outcome. The third patient, who had been comatose for at least 12 hours before surgery, died despite intervention. CONCLUSIONS: Our data suggest that decompressive hemicraniectomy can be life-saving and can result in an excellent outcome in patients with severe CVST.
BACKGROUND AND PURPOSE: Thirteen percent of patients with cerebral venous and sinus thrombosis (CVST) has a poor clinical outcome. In patients with a poor prognosis, endovascular thrombolysis can be considered, but this procedure does not appear to be beneficial in patients with impending transtentorial herniation because of large hemorrhagic venous infarcts. Therefore, halfway through 2006, we changed our policy to decompressive hemicraniectomy in these patients. METHODS:Patients with CVST and impending herniation attributable to venous infarcts were eligible for surgical intervention. Since 2006 we consecutively treated 3 patients with decompressive hemicraniectomy. Two patients had an excellent outcome. The third patient, who had been comatose for at least 12 hours before surgery, died despite intervention. CONCLUSIONS: Our data suggest that decompressive hemicraniectomy can be life-saving and can result in an excellent outcome in patients with severe CVST.
Authors: Sudeepta Dandapat; Edgar A Samaniego; Viktor Szeder; Fazeel M Siddiqui; Gary R Duckwiler; Ume Kiddy; Waldo R Guerrero; Binbin Zheng; David Hasan; Colin Derdeyn; Santiago Ortega-Gutierrez Journal: Interv Neuroradiol Date: 2019-07-31 Impact factor: 1.610
Authors: Christian Dohmen; Norbert Galldiks; Walter Moeller-Hartmann; Gereon R Fink; Lars Timmermann Journal: Neurocrit Care Date: 2010-02 Impact factor: 3.210
Authors: Christina M Kowoll; Julia Kaminski; Verena Weiß; Julian Bösel; Wenke Dietrich; Eric Jüttler; Julia Flechsenhar; Albrecht Guenther; Hagen B Huttner; Wolf-Dirk Niesen; Thomas Pfefferkorn; Ingo Schirotzek; Hauke Schneider; Thomas Liebig; Christian Dohmen Journal: Neurocrit Care Date: 2016-12 Impact factor: 3.210