• João Paulo Mattos, Andrei Fernandes Joaquim, João Paulo Cavalcante de Almeida, Lucas Alverne Freitas de Albuquerque, Elton Gomes da Silva, Horácio Armando Marenco, and Evandro de Oliveira.
• Neurosurgery Department, UNICAMP, Campinas SP, Brazil.
• Arq Neuropsiquiatr. 2010 Jun 1;68(3):339-45.

AbstractTwenty one patients were submitted to decompressive craniectomy for massive cerebral infarct. Ten patients (47.6%) presented a good outcome at the 6 months evaluation, eight had a poor outcome (38%) and three died (14.2%). There was no outcome statistical difference between surgery before and after 24 hours of ictus, dominant and non-dominant stroke groups. Patients older than 60 years and those who had a Glasgow Coma Scale (GCS)<8 in the pre-surgical exam presented worst outcome at six months (p<0.05). Decompressive craniectomy for space-occupying large hemispheric infarction increases the probability of survival. Age lower than 60 years, GCS >8 at pre-surgical exam and decompressive craniectomy before signs of brain herniation represent the main factors related to a better outcome. Dominant hemispheric infarction does not represent exclusion criteria.

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