Decompressive craniectomy in posterior fossa infarction: Clinical Implications

Solapas principales

Alvis H.1., Alcalá G.2., Godoy D.3., Moscote L.2.

ABSTRACT:

The massive cerebellar infarction is much less common than ischemic stroke in the anterior circulation; there is great variability in its definition. Occur more frequently in younger patients and with fewer comorbidities than those occurring in the anterior circulation, being generally embolic, but also highlights the occlusion of the main arteries of the posterior circulation. Clinical manifestations will depend on the extent of the cerebellar commitment and simultaneous involvement of the brain stem, although the clinical expression is generally nonspecific.

CT and MRI remain the initial imaging studies. Most use fulimagenological modality for the identification of the ischemic area are the diffusion sequences (DWI-ADC), given its large sensibility. The management always emphasizes patient stabilization, protection of the airway, adequate oxygenation, blood pressure management, glycemic control, eutermia, and prevention of deep vein thrombosis and pulmonary thromboembolism. Despite knowledge of these diagnostic and therapeutic tools, described in this review, mortality from ischemic events in the posterior fossa remains high, at around 43%, which requires the tracking of clarification regarding its etiology, diagnostic processes, and therapeutic, especially in the critical part.

 

Keyword: Descompressive craniectomy, posterior fossa, infarction cerebellar, suboccipital craniectomy

 

 

 

  1. Médico Universidad de Cartagena
  2. Neurocirujano Universidad de Cartagena
  3. Sanatorio Pasteur, Catamarca, Argentina

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