دورية أكاديمية
أعرض في EDS

Decompressive hemicraniectomies as damage control for ruptured intracranial arteriovenous malformations: A case series

التفاصيل البيبلوغرافية
العنوان: Decompressive hemicraniectomies as damage control for ruptured intracranial arteriovenous malformations: A case series
المؤلفون: Raphael Bertani, Stefan W. Koester, Karl R. Abi-Aad, Anna R. Kimata, Kevin L. Ma, Caio Perret, Ruy Monteiro
المصدر: Interdisciplinary Neurosurgery, Vol 25, Iss , Pp 101270- (2021)
بيانات النشر: Elsevier, 2021.
سنة النشر: 2021
المجموعة: LCC:Surgery
LCC:Neurology. Diseases of the nervous system
مصطلحات موضوعية: Arteriovenous malformation, AVM, Decompressive hemicraniectomy, Decompressive craniectomy, Damage control, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
الوصف: Arteriovenous malformations (AVMs) of the brain are abnormal connections between the arterial and venous cerebral vasculature that often lead to intracranial hemorrhage (ICH). The diagnosis of AVMs often takes place in the setting of ICH, however, there is no clear consensus on how to manage critically ill, comatose patients and whether it is best to treat the lesion initially. We present an initial treatment strategy that is focused on the management of intracranial hypertension by the means of decompressive craniectomy (DC) coupled with delayed AVM management. We retrospectively reviewed the medical records of three patients who arrived with ICH, obliterated cisterns, and midline shifts greater than 5mm from ruptured AVMs. Each of these patients received a DC, with later definite treatment for their AVMs and cranioplasties. We reported the preoperative and postoperative clinical status of patients using Glasgow Coma Scale (GCS) outcomes as well as physical exam findings. All three patients were transferred to the intensive care immediately after DC and had significant clinical improvement 15 days post-craniectomy. All patients underwent definitive AVM treatment within 6 weeks of the initial procedure. One patient was treated with endovascular-only embolization while the other two received surgical treatment. Patients showed a significant improvement in neurological status and clinical outcome. Decompressive hemicraniectomies may have a positive impact on mortality and neurological outcomes for select patients with cerebral hemorrhage originating from vascular malformations, especially in low-resource scenarios.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2214-7519
Relation: http://www.sciencedirect.com/science/article/pii/S2214751921001821; https://doaj.org/toc/2214-7519
DOI: 10.1016/j.inat.2021.101270
URL الوصول: https://doaj.org/article/5ea65c5b5c074fbd91b083a0041e98c1
رقم الأكسشن: edsdoj.5ea65c5b5c074fbd91b083a0041e98c1
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:22147519
DOI:10.1016/j.inat.2021.101270