Posterior Inferior Cerebellar Artery Infarction, Surgical Intervention and Outcome | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 141, Volume 87, Issue 1, April 2022, Pages 1835-1842 PDF (658.77 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2022.230278 | ||
| Authors | ||
| Abdin K. Kasim* ; Bahaa Ghareeb Hassanin; Mohamed Abdala Abbas; Karam Kenawy | ||
| Abstract | ||
| Background: Posterior inferior cerebellar artery (PICA) infarcts are the most common of the cerebellar strokes and generally produce the largest infarcts with major complications including obstructive hydrocephalus and downward herniation of the cerebellar tonsils. Surgical intervention is widely accepted treatment choice but little data is available about the procedure and outcome. Objective: The aim of the current work was to evaluate the role of suboccipital decompression craniectomy, atlas laminectomy, cerebellar tonsillectomy and duraplasty, in the management of isolated PICA territory infarction. Patients and Methods: 12 patients, 7 males and 5 females, with PICA infarcts, were subjected to surgical intervention with pre-operative and 1-month post-operative clinical and radiological assessment using the Glasgow Coma Scale (GCS), the National Institutes of Health Stroke Scale (NIHSS), Barthel ADL index and Rankin scale in conjunction with CT and / or MRI brain. Results: There are significant improvements in post-operative as compared to pre-operative assessment in different scales used in the study including the GCS, NIHSS, Barthel ADL index and Rankin Scale. Radiological evaluation showed obvious decompression of the brainstem and fourth ventricle. Conclusions: It could be concluded that suboccipital craniectomy, atlas laminectomy and duraplasty are very effective treatment for patients with large PICA infarctions and can reverse effects of brainstem compression and hydrocephalus in most cases. | ||
| Keywords | ||
| PICA infarction; Suboccipital craniectomy; Tonsillar herniation | ||
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