Objectives: To evaluate surgical results, then propose some prognostic factors for large supratentorial cerebral infarction. Subjects and methods: A prospective, uncontrolled interventional study on 75 patients who were diagnosed and performed the decompressive craniectomy due to cerebral infarction at Cho Ray Hospital from May 2003 to September 2016. | Journal of military pharmaco-medicine no4-2018 DECOMPRESSIVE CRANIECTOMY FOR LARGE SUPRATENTORIAL INFARCTION IN CHO RAY HOSPITAL Truong Da*; Bui Quang Tuyen** SUMMARY Objectives: To evaluate surgical results, then propose some prognostic factors for large supratentorial cerebral infarction. Subjects and methods: A prospective, uncontrolled interventional study on 75 patients who were diagnosed and performed the decompressive craniectomy due to cerebral infarction at Cho Ray Hospital from May 2003 to September 2016. Results: The decompressive craniectomy was conducted within 48 hours after stroke for 40% patients (30/75) without mortality; within 60 hours after stroke for 19 patients (1 death); 13 patients within 72 hours after stroke (2 deaths) and 10 patients (60%) within 96 hours after stroke (6 deaths). The largest open skull portion size was 16 x 12 cm (no mortality in a total of 17 cases); the smallest size was 12 x 12 cm (8 out of 26 cases deaths). Postoperative complications occurred in 15/75 cases (20%), of which: small bleeding scattered in the infarction area for 2/75 (); incision infection was the most common complication seen in 8/75 cases (); local seizures for 3/75 (4%) and cardiovascular disorders for 2/75 cases (). Conclusion: The later the operation, the higher the mortality rate. The smaller the open skull portion size, the higher the mortality rate (p 14 - 16 cm or > 399 cm2 compared to a large size > 12 cm or 308 cm2 would increase the recovery rate 3 months after stroke [4]. According to Kristian et al (1997) [4] among 43 decompressive craniectomy cases for space-occupational hemispheric infarction treatment, it was found that the survival rates was and no patient was under vegatative state. The average size of the open skull portion was ± cm2 and average distance from the Among the 75 cases in the study, we performed decompressive craniectomy for 17 cases with the largest size of 16 x 12 cm (192 cm2) and .
