Decompressive craniectomy for massive cerebral infarction with enlarged cruciate duraplasty.

The use of decompressive craniectomy for massive cerebral infarction is attracting renewed interest because conventional medical treatment is associated with high mortality. The technique of duraplasty may be important. We have developed a 4 step volume-enlarged cruciate duraplasty and report its use in 12 patients with massive cerebral infarction. None of the patients needed an additional anterior temporal lobectomy to reduce intraoperative intracranial pressure and none suffered epilepsy after the operation. This initial experience suggests that the use of a stepwise cruciate duraplasty during a decompression may promote clinical outcomes and further evaluation is merited.