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Revista Uruguaya de Medicina Interna

Print version ISSN 2393-6797On-line version ISSN 2393-6797


JAUME, Alejandra et al. Decompressive craniectomy in ischemic ACV: Report of 8 cases. Rev. Urug. Med. Int. [online]. 2016, vol.1, n.3, pp.92-103. ISSN 2393-6797.

ABSTRACT   Introduction: The stroke is the most expensive disease that exist, being the second leading cause of death and the leading cause of disability. Increased life expectancy has determinated an increase of risk factors for this disease. 2542 uruguayans or seven people per day died from stroke in 2012. Methods: A retrospective analysis was performed with all patients admitted at Hospital de Clinicas with diagnosis of ischemic stroke, from August 2014 to the same month of 2015. 139 patients had diagnosis of stroke, 8 (5,8%) of them needed decompressive craniectomy. Results: Six men and 2 women. 54,8 was the average age (36 - 71). 75% present with NHISS of 16 or more. 50% of patients were treated with rTPA iv. None patient had an early vascular study. Only 5 patients were admitted at stroke units. In 75% of cases, a decompressive craniectomy was performed in the first 48 hours. 37,5% of patients died in the first 15 days from the onset of symptoms. 62,5% of patients were alive with a mRS of 3 or more. Conclusion: Patients with ischemic stroke should be treated by a multidisciplinary team with all the necessary tools (stroke unit; rTPA iv, and endovascular treatment) to give the patient the best chance of a diagnosis, effective treatment and early rehabilitation. Patients under 60 years, with a malignant stroke and a negative evolution in spite of the treatment previously mentioned, benefit from a decompressive craniectomy.

Keywords : ischemic stroke; trombolytic; endovascular; decompressive craniectomy; stroke prognosis.

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