Retrospective investigation of decompressive craniectomies performed secondary to cerebrovascular disease

Cerebrovascular disesases (stroke) are the most common cause of death in the world after malignancies and cardiac diseases. In our study, it was aimed to investigate the effects of the decompressive craniectomy method used in the treatment of cerebrovascular diseases on the survival of patients and their quality of life in the postoperative period. 54 patients who had a stroke between 2010 and 2020 and underwent decompression surgery in our clinic were included in the study. The demographic information of the patients, the vascular structure causing the stroke, the affected hemisphere, preoperative and postoperative examinations, motor deficits, imaging and survival after surgery were recorded. Craniectomy areas were calculated from postoperative CCTs. 53,7% of the patients were male. The mean age was determined as 64,87±12,61. 46,3% of the patients were 65 years or younger. The right hemispheres of the patients were affected in 59,3%. When the occluded artery distributions of the patients were examined, 85,2% of them were MCA and 14,8% of them were ICA. When the preoperative GCS of the patients were compared with their mortality, it was observed that the mortality rate was higher in patients who entered the operation with a lower GCS and there was a statistically significant difference between them (p<0,05). It was evaluated whether the basal cisterns were open in the CCTs of the patients taken in the preoperative period and it was found that the mortality rate was lower in patients with open basal cisterns and there was a statistically significant difference. Decompression surgery is a life-saving surgery and has been applied for many years in cases where there is no adequate response to medical treatment for the mass effect and edema developed after stroke. We have shown that decompression surgery is a beneficial procedure for patients when applied to appropriate patient and time.