IMPACT OF DECOMPRESSIVE CRANIOTOMY ON OUTCOME OF SPONTANEOUS INTRACRANIAL HEMORRHAGE
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Abstract
Introduction: The effectiveness of decompressive craniotomy in the spontaneous intracranial hemorrhage (ICH) has always provoked question and concerns within the medical field especially from neurosurgeons and critical care physicians.
Objective: The main objective of the study is to find the impact of decompressive craniotomy on outcome of spontaneous intracranial hemorrhage.
Methodology: This prospective observational study was conducted at PIMS, Islamabad during July 2023 to June 2024. Data were collected from 110 patients who were diagnosed with spontaneous ICH and underwent decompressive craniotomy. At the time of admission all the patients were evaluated by performing a detailed neurological examination and undergoing preliminary imaging procedures. Results: The study included 110 patients with a mean age of 52.5 ± 12.4 years, ranging from 35 to 65 years. The majority of patients were male (61.8%), with 40.9% having hypertension, 27.3% with diabetes, and 13.6% with a history of previous stroke. The initial Glasgow Coma Scale (GCS) score was 8.2 ± 3.5, with over half of the patients (54.5%) presenting with a GCS score of 8 or less, indicating severe neurological impairment. Mean timing of surgery was 6.8 ± 2.3 hours after symptom onset, with an average surgery duration of 3.2 ± 1.1 hours. The mean size of the bone flap removed was 12.5 ± 2.4 cm.
Conclusion: It is concluded that decompressive craniotomy can significantly reduce mortality in patients with severe spontaneous intracranial hemorrhage, particularly in those with large hematomas and midline shifts.
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Dr Ali Raza
Neurosurgical Resident, PIMS, Islamabad
Dr Lal Rehman
Professor Head of Department, Neurosurgery PIMS, Islamabad
Dr Faizullah Khan
Senior Registrar, Neurosurgery department PIMS, Islamabad
Dr Naveed Ahmed
Neurosurgical Resident, PIMS, Islamabad
Dr Naveed Khan
Neurosurgical Resident PIMS, Islamabad
Dr Muhammad Nauman Haider
Neurosurgical Resident PIMS, Islamabad
Dr Mashal Rasool
FCPS Neurosurgery