Document Detail


Long-term outcome after surgical treatment for space-occupying cerebellar infarction: experience in 56 patients.
MedLine Citation:
PMID:  19574554     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Surgical management of space-occupying cerebellar infarction is still controversial. Data on long-term outcome are lacking. The objective of this study was (1) to evaluate outcome after at least 3 years poststroke in patients with space-occupying cerebellar infarction treated by ventriculostomy/extraventricular drainage (EVD) or suboccipital decompressive craniectomy (SDC), or both, and (2) to determine predicting factors for outcome. METHODS: In this retrospective single-center study 56 consecutive patients with acute space-occupying cerebellar infarction treated surgically between 1996 and 2005 were included. Baseline data included clinical findings, Glasgow Coma Scale on admission and before surgery, NIHSS on admission, mass effects on neuroimaging, and surgical treatment strategies. Modified Rankin Scale, NIHSS, and Scale for the Assessment and Rating of Ataxia were used to assess outcome. RESULTS: 39.3% of patients had died, 51.8% had a mRS < or =3, 35.7% had a mRS < or =2, 28.6% had a mRS < or =1. There were no significant differences in survival between treatment groups. In multivariate analysis age and mRS score at discharge were the most evident independent predictors for outcome. CONCLUSIONS: So far this is the largest study on long-term outcome after space-occupying cerebellar infarction. The value of different treatment strategies and prognostic factors for patient selection remain unclear and should be evaluated in larger prospective case-series or registries. To investigate the issue of preventive SDC randomized trials are needed.
Authors:
Eric Jüttler; Sonja Schweickert; Peter A Ringleb; Hagen B Huttner; Martin Köhrmann; Alfred Aschoff
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Publication Detail:
Type:  Journal Article     Date:  2009-07-02
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  40     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-27     Completed Date:  2009-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3060-6     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Heidelberg, Heidelberg, Germany. eric.juettler@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cerebral Infarction / mortality*,  surgery*
Decompression, Surgical*
Disease-Free Survival
Female
Humans
Male
Middle Aged
Retrospective Studies
Survival Rate
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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