Trial of Prophylactic Decompressive Craniectomy for Poor-grade Aneurysmal Subarachnoid Hemorrhage

Launched by TANG-DU HOSPITAL · Dec 14, 2016

Keywords

ClinConnect Summary

Aneurysmal subarachnoid hemorrhage (aSAH) is a worldwide health burden with high fatality and permanent disability rates. Decompressive craniectomy, which is beneficial in patients with malignant middle cerebral artery infarction, may indirectly relieve the mass effect, decrease perihematomal tissue pressure, improve blood flow, reduce secondary brain damage and improve outcome without further damage to the brain due to surgery. Early therapy with either surgical clipping or neuroradiologic intervention with endovascular coiling is the primary treatment for aSAH. But whether decompressive c...

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Eligibility criteria

• Inclusion Criteria:
• • Age\>18yrs and age\<60yrs
• • It shows subarachnoid hemorrhage (SAH) based on computed tomography (CT) scan on admission
• • Aneurysmal subarachnoid hemorrhage confirmed by computed tomography angiography (CTA), magnetic resonance angiography (MRA) or digital subtraction angiography (DSA)
• • Presentation to our institution in World Federation of Neurological Societies (WFNS) Grade III to V neurological condition with Lateral hematoma
• • Duration from onset to admission is within 48 hours
• Exclusion Criteria:
• • Traumatic subarachnoid hemorrhage
• • Patients with cerebral herniation or highly possible to occur before surgery
• • Neurosurgery contraindicated
• • Patients with obvious evidence of acute hydrocephalus on admission
• • Intracranial aneurysm combined with cerebral arteriovenous malformation
• • Patients with obvious evidence of irreparable brainstem or thalamic injury
• • Duration from onset to admission is more than 48 hours
• • Disturbance of communication or poor compliance to blood collection, imageological examination and follow-up