Some of the most dramatic recoveries were in patients in their 20s, says Carter. But even older patients had improved ability to communicate and walk, when compared with patients who did not have the procedure. These are patients that would have normally died. When they get to this severe stage, there's not a treatment option. During the three months or so it takes for the brain swelling to end, the removed portion of the skull is placed just under the skin in the abdomen for safekeeping until it's ready to be replaced.
Most patients wear a special helmet during the healing process.
In addition, many choose to undergo a cranioplasty, in which the bone is re-inserted to fill in any remaining holes in the skull. Hemicraniectomy has been used as far back as the late 1800s, but the procedure fell out of favour after patients suffered severe disabilities, such as being left in a vegetative coma. However, this study shows effectiveness can be improved if the surgery is performed within approximately 24 hours after a major stroke. Carter says that because hemicraniectomy can be performed by most neurosurgeons, it should be made available in more than just major health centres. Even at the stage where you have a very severe stroke, there are options which may have not been previously considered that can save a good proportion of patients.