Lee Ming-Hsueh, Yang Jen-Tsung, Weng Hsu-Huei, Cheng Yu-Kai, Lin Martin Hsiu-Chu, Su Chen-Hsing, Chang Chia-Mao, Wang Ting-Chung
Department of Neurosurgery, Chang Gung Memorial Hospital, Chia-Yi Center, Chiayi, Taiwan.
Clin Neurol Neurosurg. 2012 Jul;114(6):555-9. doi: 10.1016/j.clineuro.2011.11.027. Epub 2011 Dec 17.
The aim of this study was to evaluate the incidence of hydrocephalus and understand the influence of hydrocephalus on the functional outcome of patients undergoing decompressive craniectomy for malignant middle cerebral artery (MCA) infarction.
We retrospectively analyzed data of consecutive patients who underwent decompressive craniectomy for malignant MCA infarction. Clinical and imaging data were reviewed to confirm the incidence of hydrocephalus and evaluate the impact of hydrocephalus on functional outcome. The functional outcomes of patients were estimated with the Glasgow outcome score at 1year after stroke onset.
Seventeen patients who received decompressive craniectomy for malignant MCA infarction from January 2003 to December 2006 were enrolled. Persistent hydrocephalus developed in 5 patients. The functional outcomes in these patients were uniformly poor regardless of cerebrospinal fluid diversion surgery. Our data revealed that functional outcome was related to patient age and the duration from infarction to craniectomy.
Persistent hydrocephalus is common in patients who receive decompressive craniectomy for malignant MCA infarction. However, the shunt procedure does not significantly improve the patient's clinical condition. The timing of operation in relation to the functional outcome may be critical.
本研究旨在评估脑积水的发生率，并了解脑积水对接受恶性大脑中动脉（MCA）梗死减压颅骨切除术患者功能预后的影响。
我们回顾性分析了连续接受恶性MCA梗死减压颅骨切除术患者的数据。对临床和影像学数据进行回顾，以确定脑积水的发生率，并评估脑积水对功能预后的影响。采用卒中发病后1年的格拉斯哥预后评分评估患者的功能预后。
纳入了2003年1月至2006年12月期间因恶性MCA梗死接受减压颅骨切除术的17例患者。5例患者出现持续性脑积水。无论是否进行脑脊液分流手术，这些患者的功能预后均较差。我们的数据显示，功能预后与患者年龄以及梗死至颅骨切除术的时间有关。
在接受恶性MCA梗死减压颅骨切除术的患者中，持续性脑积水很常见。然而，分流手术并不能显著改善患者的临床状况。手术时机与功能预后的关系可能至关重要。
