Children's Neuroscience Centre, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.
Pediatr Neurol. 2012 Sep;47(3):193-7. doi: 10.1016/j.pediatrneurol.2012.05.005.
Few reports address the role of decompressive craniectomy in children with space-occupying cerebral edema attributable to severe ischemic infarction of the posterior cerebral arterial circulation. We describe four children with posterior circulation arterial ischemic stroke who required decompressive craniectomy. These children accounted for 11% of all cases of posterior circulation ischemic stroke at our institution from 2002-2010. Three manifested large, cerebellar hemispheric infarcts, and one manifested a large, temporo-occipital posterior cerebral artery infarct. Deterioration occurred within 72 hours of stroke onset. Two patients demonstrated minimal functional deficits at follow-up, and two demonstrated moderate deficits with functional limitations. Because decompressive craniectomy can be lifesaving in children with severe posterior circulation arterial ischemic stroke, early neurosurgical referral should be considered.
鲜有报道探讨去骨瓣减压术在由大脑后动脉循环严重缺血性梗死引起的占位性脑水肿儿童中的作用。我们描述了 4 例需要行去骨瓣减压术的大脑后循环动脉缺血性卒中患儿。这些患儿占 2002-2010 年我们机构所有后循环缺血性卒中病例的 11%。3 例表现为大的小脑半球梗死，1 例表现为大的颞枕叶大脑后动脉梗死。发病后 72 小时内病情恶化。2 例患者在随访时仅有轻微的功能缺损，2 例患者有中度功能缺损伴功能受限。由于去骨瓣减压术可挽救严重的大脑后循环动脉缺血性卒中患儿的生命，故应早期神经外科转诊。
