지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Objective : Life-threatening hemispheric stroke is associated with a high mortality and morbidity. Decompressive hemicraniectomy has been regarded as an effective treatment option for refractory intracranial hypertension. Here, we reported the clinical course of 5 children with decompressive craniectomy and duroplasty after non-traumatic refractory intracranial hypertension. Methods : Four toddlers and one preschool-girl were included in this study; there were 3 boys and 2 girls with a mean age of 34.6 months (range 17-80). Decompressive craniectomy including duroplasty was performed in cases of dilatation of pupil size after intensified standard medical therapy had proven insufficient. All children had a Pediatric Glasgow Coma Scale score <8 at pre-operation state. The mean time-point of craniectomy after stroke attack was 12 hours (range 4-19). Results : During the long-term follow-up period (mean 47.6 months), no children died. One year later, when we checked their Glasgow Outcome Scale scores, only one toddler received a score of 4 (moderate disability). But the others had good recoveries although they had minor physical or mental deficits. According to the Pediatric Cerebral Performance Category Scale, 4 children received a score of 2 (mild disability). Conclusion : Despite our small cases, we suggest that decompressive hemicraniectomy and duroplasty is an acceptable and life-saving treatment for refractory intracranial hypertension after unilateral hemispheric stroke in toddlers and preschool children.
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참고문헌 (21)
참고문헌 신청
Adams HP Jr / 2007 / Guidelines for the early management of adults with ischemic stroke : a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups : The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists / Circulation 115:478~534
Aghakhani N / 2009 / Decompressive craniectomy in children with nontraumatic refractory high intracranial pressure. Clinical article / J Neurosurg Pediatr 3:66~69
Carter BS / 1997 / One-year outcome after decompressive surgery for massive nondominant hemispheric infarction / Neurosurgery 40:1168~1175
Chesnut RM / 1997 / The management of severe traumatic brain injury / Emerg Med Clin North Am 15:581~604
Chi CS / 1990 / Continuous monitoring of intracranial pressure in Reye’s syndrome--5 years experience / Acta Paediatr Jpn 32:426~434
Aghakhani N / 2009 / Decompressive craniectomy in children with nontraumatic refractory high intracranial pressure. Clinical article / J Neurosurg Pediatr 3:66~69
Carter BS / 1997 / One-year outcome after decompressive surgery for massive nondominant hemispheric infarction / Neurosurgery 40:1168~1175
Chesnut RM / 1997 / The management of severe traumatic brain injury / Emerg Med Clin North Am 15:581~604
Chi CS / 1990 / Continuous monitoring of intracranial pressure in Reye’s syndrome--5 years experience / Acta Paediatr Jpn 32:426~434
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