Decompressive hemicraniectomy for pediatric traumatic brain injury: Long-term outcome based on quality of life

Arun T. Jacob, Gregory G. Heuer, Ryan Grant, Patrick Georgoff, Shabbar F. Danish, Phillip B. Storm, Sherman C. Stein

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Aims: The impact of decompressive hemicraniectomy (DCH) on the overall outcome of pediatric brain injury patients has not been fully determined. In this paper, the authors performed a systematic review of patient outcome based on quality of life following DCH in a pediatric population. Methods: We describe our experience with decompressive craniectomy in pediatric patients and perform a literature review and pooled outcomes analysis to supplement these findings. A total of 13 children underwent DCH for intractable intracranial pressure in our institution from 2000 to 2008. Follow-up was available in 11 patients with 1 death (9%) and 7 survivors (70%) obtaining a favorable outcome (Glasgow Outcome Scale, GOS, scores = 4-5). Results: A literature review to determine the usefulness of DCH identified 17 articles that, when combined with our series, resulted in 186 pediatric DCH cases. Pooled outcomes found 42 deaths and 112 patients who had favorable outcomes at 6 months. The average 6-month mortality was 21.1%, and the pooled mean quality of life among survivors 0.75 (0.68-0.82), midway between moderate disability and good outcome. Conclusions: Based on our findings, DCH results in a majority of pediatric patients having a good outcome based on the GOS score.

Original languageEnglish (US)
Pages (from-to)81-86
Number of pages6
JournalPediatric Neurosurgery
Volume47
Issue number2
DOIs
StatePublished - Oct 2011

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Surgery

Keywords

  • Hemicraniectomy, outcome
  • Pediatric traumatic brain injury
  • Quality of life

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