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<p>Decompressive craniectomy (DC) has been reported as a risk factor for communicating hydrocephalus, but no studies have directly compared DC and non-DC groups to determine the odds ratio (OR) for ventriculomegaly, particularly in malignant cerebral infarction. This study aims to calculate the OR for ventriculomegaly after DC and identify associated risk factors.&#xa0;Data from two primary stroke centers in Japan (2010–2024) were analyzed. Among 385 malignant ischemia cases, this study included 100 patients who underwent decompressive craniectomy (DC group), while 96 who did not (non-DC group). Propensity score matching (1:1) was performed. Data from 37 DC group and 27 non-DC group patients with imaging available at 6 months post-onset were analyzed. Measurements and comparisons were made for the Evans index, the width of the ipsilateral and contralateral lateral ventricles, and the third ventricle at the onset and 6 months post-onset.&#xa0;After matching, 49 cases per group were analyzed. Ventriculomegaly was significantly higher in the DC group (OR: 4.55). The DC group also showed significantly greater increases in Evans index, ipsilateral and contralateral lateral ventricle, and third ventricle ratio.&#xa0;Based on radiological findings, DC is an independent risk factor for ventriculomegaly. It is essential to recognize that DC increases the risk of postoperative ventriculomegaly, even in cases of cerebral infarction.</p>

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Decompressive craniectomy following malignant cerebral infarction is an independent risk factor for ventriculomegaly

  • 期刊论文

  • 发表日期：

    2025年11月22日

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  • Masashi Higashino,
  • Eiji Kurihara,
  • Ryuichi Kuroda,
  • Satoshi Inoue,
  • Tae Jin Lee,
  • Takashi Mizowaki,
  • Masafumi Mori,
  • Narihide Shinoda,
  • Shogo Tamura,
  • Naoya Takeda

摘要

Decompressive craniectomy (DC) has been reported as a risk factor for communicating hydrocephalus, but no studies have directly compared DC and non-DC groups to determine the odds ratio (OR) for ventriculomegaly, particularly in malignant cerebral infarction. This study aims to calculate the OR for ventriculomegaly after DC and identify associated risk factors. Data from two primary stroke centers in Japan (2010–2024) were analyzed. Among 385 malignant ischemia cases, this study included 100 patients who underwent decompressive craniectomy (DC group), while 96 who did not (non-DC group). Propensity score matching (1:1) was performed. Data from 37 DC group and 27 non-DC group patients with imaging available at 6 months post-onset were analyzed. Measurements and comparisons were made for the Evans index, the width of the ipsilateral and contralateral lateral ventricles, and the third ventricle at the onset and 6 months post-onset. After matching, 49 cases per group were analyzed. Ventriculomegaly was significantly higher in the DC group (OR: 4.55). The DC group also showed significantly greater increases in Evans index, ipsilateral and contralateral lateral ventricle, and third ventricle ratio. Based on radiological findings, DC is an independent risk factor for ventriculomegaly. It is essential to recognize that DC increases the risk of postoperative ventriculomegaly, even in cases of cerebral infarction.