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Decompressive Hemicraniectomy in Children With Severe Ischemic Stroke and Life-Threatening Cerebral Edema

Departments of Pediatrics, University of Alberta, Department of Section of Pediatric Neurosciences, University of Alberta

Vivek Mehta, MD

Department of Neurosurgery, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada

Mary Bauman, NP

Departments of Pediatrics, University of Alberta

Lawrence Richer, MD

Departments of Pediatrics, University of Alberta, Department of Section of Pediatric Neurosciences, University of Alberta

Patti Massicotte, MD

Departments of Pediatrics, University of Alberta

Jerome Y. Yager, MD

Departments of Pediatrics, University of Alberta, Department of Section of Pediatric Neurosciences, University of Alberta, jyager{at}ualberta.ca

Decompressive hemicraniectomy has been discussed as a treatment option that increases survival in adults with malignant stroke. This approach has not been studied extensively in children. From a prospective cohort, we identified 4 children who underwent decompressive hemicraniectomy for malignant infarctions with life-threatening cerebral edema within 72 hours of their stroke. All 4 children had different causes for their stroke and experienced severe cerebral edema with increasing intracranial pressure and an impending fatal outcome. Despite massive cerebral infarction, all patients were ambulant and able to speak at the time of follow-up. Although a limited experience, decompressive hemicraniectomy is a life-saving approach for malignant stroke in children.

Key Words: stroke • craniectomy • hemispheric stroke • decompressive hemicraniectomy

This version was published on August 1, 2008

Journal of Child Neurology, Vol. 23, No. 8, 889-894 (2008)
DOI: 10.1177/0883073808314960


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