From 2009 to mid-2013, 229 hemicraniectomies were reported in Riks-Stroke, of which 43 were performed in patients with intracerebral hemorrhage. In patients with brain infarction, it was performed in 0.19% (all ages) and 1.07% (below 60 years), higher than reported from the US. Of the hemicraniectomies, 45% were performed in patients above 60 years. Survival was 83% at 3 months and 81% at 12 months, similar to survival reported in the literature. Three months after hemicraniectomy, 69% of survivors responded to a follow-up questionnaire. Of these, 31% were independent in personal ADL and 46% were living at home. Case fatality was higher but functional outcome in survivors was similar in patients above 60 years compared to below 60. In conclusion, outcomes are similar in Sweden to those reported in randomized trials and international observational studies. With proper patient selection, it seems that hemicraniectomy may also benefit patients above 60 years.
Lakartidningen.se 2014-01-28