Efficacy of decompressive craniectomy: A retrospective case series study with 321 patients and an update on controversies

Gatos,Charalampos; Fotakopoulos,George; Tasiou,Anastasia; Christodoulidis,Grigorios; Georgakopoulou,Vasiliki Epameinondas; Spiliotopoulos,Theodosis; Kalogeras,Adamantios; Sklapani,Pagona; Trakas,Nikolaos; Paterakis,Konstantinos; Fountas,Kostas N.

doi:10.3892/mi.2024.188

Efficacy of decompressive craniectomy: A retrospective case series study with 321 patients and an update on controversies

Authors:
- Charalampos Gatos
- George Fotakopoulos
- Anastasia Tasiou
- Grigorios Christodoulidis
- Vasiliki Epameinondas Georgakopoulou
- Theodosis Spiliotopoulos
- Adamantios Kalogeras
- Pagona Sklapani
- Nikolaos Trakas
- Konstantinos Paterakis
- Kostas N. Fountas
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Affiliations: Department of Neurosurgery, General University Hospital of Larissa, 41221 Larissa, Greece, Department of General Surgery, General University Hospital of Larissa, 41221 Larissa, Greece, Department of Pathophysiology, National and Kapodistrian University of Athens, 11527 Athens, Greece, Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
Published online on: August 6, 2024 https://doi.org/10.3892/mi.2024.188
Article Number: 64
Copyright : © Gatos et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

Decompressive craniectomy (DC) is considered a cornerstone in the management of refractory intracranial hypertension. For decades, DC was known as an occasionally lifesaving procedure; however, it was associated with numerous severe complications. The present study is a single‑center retrospective case series study on with 321 patients who underwent DC between January, 2010 and December, 2020. All patients were divided into four groups as follows: Group A included patients who suffered from a space‑occupying middle cerebral artery (MCA) ischemic event; group B included individuals who developed intracerebral hemorrhage; group C included patients admitted for traumatic brain injury; and group D included patients with other neurosurgical entities that underwent DC, such as subarachnoid hemorrhage, tumors, brain abscess and cerebral ventricular sinus thrombosis events. The present study enrolled a total of 321 patients who underwent DC. Group A included 52 out of the 321 (16.1%) patients, group B included 51 (15.8%) patients, group C included 164 (51.0%) patients, and group D included 54 (16.8%) patients. Of the 321 patients, 235 (73.2%) were males, and the median age was 53.7 years. Multivariate analysis revealed that only the group A parameter was an independent factor associated with a Glasgow outcome scale score >2 during follow‑up (P<0.05). On the whole, the results of the present study suggest that among patients who underwent DC with different neurological entities, those who had experienced MCA events had more favorable outcomes.