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KMID : 0388420040140010135
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Konkuk Journal of Medical Sciences
2004 Volume.14 No. 1 p.135 ~ p.147
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Considerations on Decompressive Craniotomy, Stereotactic biopsy and Pathologic finding in Stroke -Considerations on Decompressive Craniotomy, Stereotactic biopsy and Pathologic finding in Stroke
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Lee Joo-Yong
Cho Joon
Han Hye-Seung
Moon Chang-Taek
Chang Sang-Keun
Park Ho-Kwon
Lee Kyeong-Ryong
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Abstract
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The authors in this manuscript aimed to provide a practical importance of the differential diagnosis of intracranial brain tumor with emphasis on non-neoplastic abnormalities such as cytotoxic edema of the penumbra zone in strokes.
The well known SOLs are cerebral ischemic, inflammatory and dysplastic lesions, which intraaxially imitate glioma and other neurogenic tumors. Brain tumor is the one of common intracranial space-occupying lesions (SOLs) on the diagnostic images. However, many non-neoplastic lesions may be indistinguishable from tumors. Especially, early mortality used to be caused by space-occupying hyperacute ischemic stroke, brain edema and herniations.
For the retrospective analysis, the authors reviewed the patient charts, the emergency brain Computerized Tomography (CT), magnetic resonance imaging (MRI), clinical stroke history. From Jan. 2003 to Dec. 2003, we managed total 61 acute strokes in ICU. Even though we operated six decompressive craniotomies, nine stereotactic craniotomies including two procedures of brain biopsy and three extraventricular drainage procedures, three patients (4.91%) were finally expired out from the induced herniation and medullary failure by those aggressive strokes. 43 patients (70.5%) were recovered good from stroke attack. 15 patients (24.6%) were improved with residual neurologic deficits.
In conclusion, aside from growing efforts of the radiologist to make the early diagnostic impression, the authors suggest that urgent neurosurgical explorations with the pathologic diagnostic decision should be requested to decrease the fatality.
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KEYWORD
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Hyperacute infarction, glioma bleeding, decompressive craniotomy, Stereotactic biopsy
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