Abbreviations: CI, confidence interval; ICH, intracerebral hemor- rhage.
*Trend toward significance. ySignificant at a level of 0.05.
autoregulation. Thus ICP increases again and reaches pathological values a few hours after removal of the hema- toma.14,15 To resolve this problem, decompressive craniec- tomy may be a choice. This surgical technique allows the edematous tissue expansion away from the lateral ventri- cle, the diencephalons, and the mesencephalon. As a result, ICP decreases while perfusion pressure increases. It, there- fore, prevents cerebral herniation and death caused by brain edema.16 These advantages obtainable with decom- pressive craniectomy combined with dural enlargement have been confirmed by some clinical studies. Dierssen et al17 reported a series of 73 patients with spontaneous ICH treated by surgical evacuation of the hematoma and decompressive craniectomy. The postoperative mortality and morbidity of the surviving patients of this series were better than their historical control subjects. A case se- ries reported by Murthy et al18 revealed that of the 12 con- secutive patients with SBH treated with decompressive hemicraniectomy, 11 patients (92%) survived to discharge, and 6 of them (54.5%) had good functional outcomes. A similar observational study conducted by Ramnarayan et