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- D J Lanzino and G Lanzino.
- Department of Neurosurgery, Derriford Hospital, Plymouth, United Kingdom.
- Neurosurg Focus. 2000 May 15; 8 (5): e3.
AbstractA subset of patients with ischemic cerebrovascular stroke suffer a progressive deterioration secondary to massive cerebral ischemia, edema, and increased intracranial pressure (ICP). The evolution is often fatal. In these patients, a decompressive craniectomy converts the closed, rigid cranial vault into an "open box." The result is a dramatic decrease in ICP and a reversal of the clinical and radiological signs of herniation. For these reasons, decompressive craniectomy has been increasingly proposed as a life-saving measure in patients with large, space-occupying hemispheric infarction. The authors review the rationale, indications, and clinical experience with this procedure, which has been performed in patients who have had supratentorial ischemic stroke.
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