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Decompressive craniectomy for infants: a case series of five patients

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Abstract

Purpose

Management of cerebral edema in infants is challenging. Decompressive craniectomy in young age has shown favorable outcomes for management of intracranial hypertension, but current literature is scarce and consists of only case reports or small series. The purpose of the current study is to report the challenges faced with this procedure and its complications in this peculiar age group.

Methods

This is a retrospective chart review of infants (less than 1 year of age) undergoing unilateral or bilateral decompressive craniotomy at a tertiary care hospital in Pakistan. Kochi score was used to score outcomes of five infants who underwent the procedure.

Results

Five infants were included in this series. Operative time for decompressive craniectomy (DC) ranged from 1 h and 40 min to 4 h. Three infants survived to undergo cranioplasty. Two infants recovered with good Kochi scores of 5a and one infant developed hemiparesis (Kochi score 3b).

Conclusions

Decompressive craniectomy carries good outcomes in selected patients. Risk of bleeding and hemodynamic instability makes this procedure challenging. We found coagulopathy in four of the five patients which poses another challenge to the surgical management of these patients and has not been stressed enough in the previous literature.

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Conflict of interest

We have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest, in the subject matter or materials discussed in this article.

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Authors and Affiliations

  1. Section of Neurosurgery, The Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, Pakistan

    Muhammad Riyaz, Muhammad Waqas, Badar Uddin Ujjan, Naveed Zaman Akhunzada, Yousaf Bashir Hadi, Gohar Javed & Muhammad Ehsan Bari

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  1. Muhammad Riyaz
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  2. Muhammad Waqas
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  3. Badar Uddin Ujjan
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  4. Naveed Zaman Akhunzada
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  5. Yousaf Bashir Hadi
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  6. Gohar Javed
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  7. Muhammad Ehsan Bari
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Correspondence to Muhammad Ehsan Bari.

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Riyaz, M., Waqas, M., Ujjan, B.U. et al. Decompressive craniectomy for infants: a case series of five patients. Childs Nerv Syst 31, 2117–2122 (2015). https://doi.org/10.1007/s00381-015-2808-1

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  • DOI: https://doi.org/10.1007/s00381-015-2808-1

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