Suboccipital Decompressive Craniectomy for Cerebellar Infarction: A Systematic Review and Meta-Analysis

World Neurosurgery
Oliver G S AylingR Loch Macdonald

Abstract

Suboccipital decompressive craniectomy (SDC) for cerebellar infarction has been traditionally performed with minimal high-quality evidence. The aim of this systematic review and meta-analysis is to investigate the impact of SDC on functional outcomes, mortality, and adverse events in patients with cerebellar infarcts. A systematic review and meta-analysis in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Our primary outcome was the proportion of patients with moderate-severe disability after SDC. Secondary outcomes included mortality and adverse events. A sensitivity analysis was conducted to examine the roles of age, preoperative neurologic status, external ventricular drain insertion, and debridement of infarcted tissue on SDC outcomes. Eleven studies (with 283 patients) met our inclusion criteria. The pooled event rate for moderate-severe disability was 28% (95% confidence interval [CI], 20%-37%) and for mortality, it was 20% (95% CI, 12%-31%). The estimated overall rate of adverse events for SDC was 23% (95% CI, 14%-35%). Sensitivity analysis found less mortality with mean age <60 years, higher rates of concomitant external ventricular drain insertion, and debride...Continue Reading

Citations

Dec 1, 2019·Zeitschrift für Gerontologie und Geriatrie·Frank Erbguth
Apr 23, 2020·Medizinische Klinik, Intensivmedizin und Notfallmedizin·Frank Erbguth
Jan 29, 2019·Frontiers in Neurology·Lars-Peder PallesenVolker Puetz
Nov 28, 2020·Journal of Neurointerventional Surgery·Isabelle MourandFederico Cagnazzo
May 6, 2021·Clinical Medicine : Journal of the Royal College of Physicians of London·Ajay BhallaJonathan Birns
Sep 26, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Martin VychopenErdem Güresir

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