Guidelines der SHG

Publication: Stroke Units und Stroke Centers in der Schweiz: Richtlinien und Anforderungsprofil

Decompressive craniectomy for space occupying hemispheric and cerebellar ischemic strokes: Swiss recommendations

The general goal of these recommendations is to unify the acute management of patients with space occupying ischemic stroke in Switzerland by applying currently available evidence, in order to decrease case fatality and morbidity of this disease. The specific objectives of these recommendations are 

(a) to avoid performing craniectomy in patients with poor prognosis despite this intervention,
(b) to avoid performing craniectomy if the risk of worsening and herniation is small,
(c) to decide on craniectomy at an early stage,
(d) to improve communication between doctors, patients and relatives, and
(e) to use adequate neurosurgical techniques and perioperative management.