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Surgical treatment of patients with unilateral cerebellar infarcts: clinical outcome and prognostic factors
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
2011 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 153, no 10, 2075-2083 p.Article in journal (Refereed) Published
Abstract [en]

There are limited data on the long-term outcome and on factors influencing the prognosis in patients with cerebellar infarcts treated with surgical decompression. Thirty-two patients (age 64.3 +/- 9.9 years) with expansive unilateral cerebellar infarcts were retrospectively evaluated. All patients were treated with ventriculostomy, suboccipital decompressive craniectomy and removal of the necrotic tissue. The Glasgow Coma Scale (GCS) and the Reaction Level Scale (RLS) scores evaluated the level of consciousness during hospitalization, while the modified Rankin Scale (mRS) was used for the 6-month and long-term outcome. Predicting factors were analyzed using a univariate logistic regression model. The median time from ictus to surgery was 48.4 h (range 8-120 h). Before surgery, the median GCS score was 9 (3-13). At discharge, the GCS score improved to 13.6 (7-15) (p < 0.05 compared to preoperative scores). At the long-term follow-up (median 67.5 months), ten patients were dead, and 77% of survivors had a good outcome (mRS score of a parts per thousand currency sign2). The number of days on a ventilator and the GCS score prior to surgery and at discharge were strong predictors of clinical outcome (p < 0.05), although one third of patients with a GCS a parts per thousand currency signaEuro parts per thousand 8 at the time of surgery had a good long-term outcome. In patients a parts per thousand yen70 years old, 50% had a good long-term outcome, and advanced age was not associated with a bad result (p > 0.05). Our results imply that surgical evacuation of significant cerebellar infarctions may be considered also in patients with advanced age and/or a decreased level of consciousness.

Place, publisher, year, edition, pages
2011. Vol. 153, no 10, 2075-2083 p.
Keyword [en]
Cerebellar infarct, External ventricular drainage, Surgical decompression, Modified Rankin Scale, Outcome, Age
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-159224DOI: 10.1007/s00701-011-1120-4ISI: 000294787400024OAI: oai:DiVA.org:uu-159224DiVA: diva2:444058
Available from: 2011-09-27 Created: 2011-09-26 Last updated: 2017-12-08Bibliographically approved

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