Therapeutic Hypothermia after Decompressive Craniectomy in
Malignant Cerebral Infarction
- Author(s)
- Jun Young Chang; Jeong-Ho Hong; Jin-Heon Jeong; Sung-Jin Nam; Ji-Hwan Jang; Jae Seung Bang; Moon-Ku Han
- Keimyung Author(s)
- Hong, Jeong Ho
- Department
- Dept. of Neurology (신경과학)
- Journal Title
- Korean Journal of Critical Care Medicine
- Issued Date
- 2014
- Volume
- 29
- Issue
- 2
- Keyword
- Brain edema; Cerebral infarction; Decompressive craniectomy; Hypothermia
- Abstract
- Decompressive hemicraniectomy followed by subsequent therapeutic hypothermia can reduce mortality in patients with malignant
cerebral infarction without significantly increasing risk. We report three cases of malignant cerebral infarction treated with hemicraniectomy
followed by hypothermia. Case 1 received elective decompressive surgery and hypothermia. Case 2 developed subsequent
cerebral infarction with uncal herniation. Therefore, emergent decompressive surgery and hypothermia was performed in this case.
Despite surgery and hyperosmolar therapy, case 3 received hypothermia treatment for refractory increased intracranial pressure. All patients
survived with a score of 4 or 5 on the modified Rankin scale. Therefore, we suggest that application of hypothermia after hemicraniectomy
is safe and feasible. Several possible modifications can be made to improve the management strategy in order to increase
the benefits of hypothermia treatment.
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