Back to Search Start Over

Functional Outcomes After Decompressive Surgery in Patients with Malignant Space-Occupying Cerebellar Infarction

Authors :
Enayatullah Baki
Lea Baumgart
Victoria Kehl
Felix Hess
Andreas Wolfgang Wolff
Arthur Wagner
Moritz Roman Hernandez Petzsche
Tobias Boeckh-Behrens
Bernhard Hemmer
Bernhard Meyer
Jens Gempt
Silke Wunderlich
Source :
Neurology International, Vol 16, Iss 6, Pp 1239-1246 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Background and Purpose: Decompressive surgery is a potentially life-saving treatment in patients with malignant space-occupying cerebellar infarction. However, there is only limited literature on functional outcomes and complications after surgery. Our aim was to establish markers which predict poor outcome. Methods: We retrospectively analyzed data of all patients who underwent surgery due to malignant swelling of a space-occupying cerebellar infarction in our hospital between 2005 and 2023. Statistical analyses were conducted on multiple parameters to identify predictors of poor functional outcome (mRS 4–6) 90 days after surgery. Complications during hospitalization were reviewed for each patient. Results: In total, 58 patients received decompressive surgery. The 90-day mortality rate was 27.6% (n = 16). A good functional outcome (mRS 0–3) 90 days after surgery was achieved in 24 patients (41.4%). Multivariable analysis revealed multiple factors associated with a poor outcome on day 90 (mRS 4–6): a higher premorbid mRS score (OR 2.715 [95% CI, 1.166–6.323]; p = 0.021), higher NIHSS score on admission (OR 1.088 [95% CI, 1.014, 1.168]; p = 0.019) and the presence of an additional brainstem infarction (OR 7.035, [95% CI, 1.255, 39.424], p = 0.027). Hyperactive delirium was associated with good clinical outcome (OR 0.020 [95%CI, 0.001–0.623]; p = 0.026). Aspiration pneumonia (n = 22, 37.9%), urinary tract infection (n = 15, 25.9%), and hyperactive delirium (n = 8, 13.8%) were the most common complications during hospitalization. Conclusions: Decompressive surgery is a safe, life-saving treatment for malignant space-occupying cerebellar infarction. Higher premorbid mRS, higher NIHSS score on admission and the presence of brainstem infarction are associated with a poor functional outcome.

Details

Language :
English
ISSN :
20358377
Volume :
16
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Neurology International
Publication Type :
Academic Journal
Accession number :
edsdoj.16205d67159f47dc9ab0b113f87dfce2
Document Type :
article
Full Text :
https://doi.org/10.3390/neurolint16060094