Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 4 Issue 8

A Comparative Study Between Decompressive Hemicraniectomy vs. Decompression with Hematoma Evacuation for Spontaneous Intracranial Hematomas Requiring Surgery in a Tertiary Care Center in Bengaluru, South India. Lessons for Rural Neurosurgeons

Rajesh Raykar1 and Sibhi Ganapathy2*

1Associate Professor, Department of Neurosurgery and Spine Surgery, St. Johns Medical College Hospital, Bengaluru, India
2Assistant Professor, Department of Neurosurgery and Spine Surgery, St. Johns Medical College and Hospital, Bangalore, India

*Corresponding Author: Sibhi Ganapathy, Assistant Professor, Department of Neurosurgery and Spine Surgery, St. Johns Medical College and Hospital, Bangalore, India.

Received: June 25, 2021; Published: July 23, 2021

Abstract

Objective: To assess the feasibility of plain decompressive hemicraniectomy in the treatment of spontaneous hypertensive intracranial bleeds as a low cost and low skill alternative for decompression and hematoma evacuation.

Methodology: A retrospective cohort analysis of all the spontaneous hypertensive bleeds operated in a tertiary care center in southern India was planned, and all surgical cases were analyzed and the mortality and morbidity difference between procedures employed were understood.

Results: Of the 36 patients operated with decompression with hematoma evacuation a high mortality rate of 26 cases was noticed (72.22%) which was significantly more than plain decompressive hemicraniectomy (8 deaths out of 20patients or 40%) was seen across all patients irrespective of preoperative GCS or comorbidities.

Conclusion: Decompressive hemicraniectomy is a viable alternative to decompression with hematoma evacuation. This is especially relevant in rural settings where expertise and equipment are in short supply and transport to higher centres implies a delay in surgery which is often associated with significant morbidity and mortality.

Keywords: Decompressive Hemicraniectomy; Decompression with Hematoma Evacuation; Spontaneous Intracranial Hematomas; Rural Neurosurgery

References

  1. Takeuchi S., et al. “Decompressive hemicraniectomy for spontaneous intracerebral hemorrhage”. Neurosurgical Focus5 (2013): E5.
  2. Fung C., et al. “Decompressive hemicraniectomy in patients with supratentorial intracerebral hemorrhage”. Stroke12 (2012): 3207-3211.
  3. Heuts SG., et al. “Decompressive hemicraniectomy without clot evacuation in dominant-sided intracerebral hemorrhage with ICP crisis”. Neurosurgical Focus5 (2013): E4.
  4. Murthy JMK., et al. “Decompressive craniectomy with clot evacuation in large hemispheric hypertensive intracerebral hemorrhage”. Neurocritical Care3 (2005): 258-262.
  5. Rasras S., et al. “Decompressive hemicraniectomy without clot evacuation in supratentorial deep-seated intracerebral hemorrhage”. Clinical Neurology and Neurosurgery 174 (2018): 1-6.
  6. Li L., et al. “Impact of Intracerebral Hematoma Evacuation During Decompressive Hemicraniectomy on Functional Outcomes”. Stroke 3 (2021): 1105-1108.
  7. Poblete RA., et al. “Older Age Is Not Associated with Worse Outcomes Following Decompressive Hemicraniectomy for Spontaneous Intracerebral Hemorrhage”. Journal of Stroke and Cerebrovascular Diseases11 (2019): 104320.
  8. Ramnarayan R., et al. “Decompressive hemicraniectomy in large putaminal hematomas: an Indian experience”. Journal of Stroke and Cerebrovascular Diseases1 (2009): 1-10.
  9. Takeuchi S., et al. “Decompressive craniectomy with hematoma evacuation for large hemispheric hypertensive intracerebral hemorrhage”. In Brain Edema XV. Springer, Vienna (2013): 277-279.
  10. Bösel J., et al. “Haemorrhage and hemicraniectomy: refining surgery for stroke”. Current Opinion in Neurology1 (2015): 16-22.
  11. Pedro KM., et al. “Decompressive hemicraniectomy without clot evacuation in spontaneous intracranial hemorrhage: A systematic review”. Clinical Neurology and Neurosurgery 192 (2020): 105730.
  12. Kim DB., et al. “Comparison of craniotomy and decompressive craniectomy in large supratentorial intracerebral hemorrhage”. Journal of Clinical Neuroscience 50 (2018): 208-213.

Citation

Citation: Rajesh Raykar and Sibhi Ganapathy. “A Comparative Study Between Decompressive Hemicraniectomy vs. Decompression with Hematoma Evacuation for Spontaneous Intracranial Hematomas Requiring Surgery in a Tertiary Care Center in Bengaluru, South India. Lessons for Rural Neurosurgeons”. Acta Scientific Neurology 4.8 (2021): 45-49.

Copyright

Copyright: © 2021 Rajesh Raykar and Sibhi Ganapathy. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate32%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US