Evidence map›Paper›PMID 41503265›Full record

ArticleBrain & spine2026

Size of decompressive craniectomy as prognostic factor in space-occupying ischemic cerebellar stroke -a multicentric retrospective study.

Silvia Hernández-Durán, Johannes Walter, Daniel Dubinski, Obada T Alhalabi, Milos Arsenovic, Daniel Cantre, Nazife Dinc, Judith Dremel, Nima Etminan, Thomas M Freiman and 26 more

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Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

36 authors.

Silvia Hernández-DuránDepartment of Neurosurgery, University Medical Center Rostock, Rostock, Germany.
Johannes WalterDepartment of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany and University of Heidelberg, Medical Faculty, Heidelberg, Germany.
Daniel DubinskiDepartment of Neurosurgery, University Medical Center Rostock, Rostock, Germany.
Obada T AlhalabiDepartment of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany and University of Heidelberg, Medical Faculty, Heidelberg, Germany.
Milos ArsenovicDepartment of Neurosurgery, University Medical Center Rostock, Rostock, Germany.
Daniel CantreDepartment of Neuroradiology, University Medical Center Rostock, Rostock, Germany.
Nazife DincDepartment of Neurosurgery, University Hospital Jena, Jena, Germany.
Judith DremelDepartment of Neurosurgery, University Hospital Mannheim, Mannheim, Germany.
Nima EtminanDepartment of Neurosurgery, University Hospital Mannheim, Mannheim, Germany.
Thomas M FreimanDepartment of Neurosurgery, University Hospital Göttingen, Göttingen, Germany.
Kiarash FerdowssianDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Erdem GüresirDepartment of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.
Katharina A M HackenbergDepartment of Neurosurgery, University Hospital Mannheim, Mannheim, Germany.
Motaz HamedDepartment of Neurosurgery, University Hospital Bonn, Bonn, Germany.
Andreas KramerDepartment of Neurosurgery, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Christopher KrämerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Beate KranawetterDepartment of Neurosurgery, University Hospital Göttingen, Göttingen, Germany.
Tim LampmannDepartment of Neurosurgery, University Hospital Bonn, Bonn, Germany.
Anne NeumeisterDepartment of Neurosurgery, University Hospital Jena, Jena, Germany.
Artem RafaelianDepartment of Neurosurgery, University Medical Center Rostock, Rostock, Germany.
Florian RingelDepartment of Neurosurgery, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Veit RohdeDepartment of Neurosurgery, University Hospital Göttingen, Göttingen, Germany.
Jan Hendrik SchäferGoethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt am Main, Germany.
Michael SchwakeDepartment of Neurosurgery, University Hospital Münster, Münster, Germany.
Christian SenftDepartment of Neurosurgery, University Hospital Jena, Jena, Germany.
Alexander StorchDepartment of Neurology, University Medical Center Rostock, Rostock, Germany.
Moritz ThielDepartment of Neurosurgery, University Hospital Münster, Münster, Germany.
Merih TurgutDepartment of Neurosurgery, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Andreas W UnterbergDepartment of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany and University of Heidelberg, Medical Faculty, Heidelberg, Germany.
Peter VajkoczyDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Hartmut VatterDepartment of Neurosurgery, University Hospital Bonn, Bonn, Germany.
Martin VychopenDepartment of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.
Johannes WachDepartment of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.
Matthias WittstockDepartment of Neurology, University Medical Center Rostock, Rostock, Germany.
Florian GesslerDepartment of Neurosurgery, University Medical Center Rostock, Rostock, Germany.
Sae-Yeon WonDepartment of Neurosurgery, University Medical Center Rostock, Rostock, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: In cases of space-occupying cerebellar ischemic strokes, guidelines recommend suboccipital decompressive surgery (SDC). While in supratentorial hemispheric stroke, the size of the bone flap has been the subject of many studies and ample debate, no studies have been conducted to determine the optimal size of the bone flap to be removed in SDC. Research question: To determine the optimal size of SDC in ischemic cerebellar stroke. Methods: This is a multicentric retrospective study of patients undergoing SDC for ischemic cerebellar stroke. SDC size was determined in two perpendicular planes on early postoperative CT scans: (a) maximal lateral extension (L) and (b) maximal craniocaudal extension (CC) in cm. The primary endpoint was functional outcome according to modified Rankin Scale (mRS) at three months. Secondary outcome was mortality at three months, as well as surgical complications. Results: A total of 88 patients were included in the final analysis. The mean L diameter of the SDC analyzed was 7 cm (SD 1.5), whereas the mean CC diameter was 4.4 cm (SD .8). When dichotomizing patients based on a threshold of L ≥ 6.5 cm, favorable outcome was more likely in the group with L ≥ 6.5 cm (OR = 3.23, 95%CI 1.02-10.56, p = .045). No statistically significant differences were observed in mortality at three months (OR = .66, 95%CI .24-1.78, p = .40). Conclusions: In ischemic cerebellar stroke, a suboccipital craniectomy with a maximum lateral diameter of ≥6.5 cm appears to yield better functional outcomes than smaller ones. Prospective studies are needed to confirm these results.

Indexed as

Cerebellar strokeSuboccipital craniectomySurgery for stroke

Identifiers

PMID41503265
PMCPMC12769817

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