Decompressive hemicraniectomy in malignant middle cerebral artery infarction: an analysis of long-term outcome and factors in patient selection

Pillai, Anju S.; Menon, Sajesh K; Kumar, Sunil; Kariyattil, Rajeev; Kumar, Anand; Panikar, Dilip

doi:10.3171/jns.2007.106.1.59

Cited by 81 publications

(73 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The use of decompressive hemicraniectomy in these patients usually does not provide any benefit and can result in severe disability, persistent vegetative state or death. Most series in the literature are retrospective studies with a low number of cases (4, 8,13,14,19). The results of these studies are similar.…”

Section: █ Conclusionsupporting

confidence: 72%

See 1 more Smart Citation

Decompressive hemicraniectomy for malignant middle cerebral artery infarct

Gülensoy

Karatay²,

Yavuz³

et al. 2014

Turkish Neurosurgery

View full text Add to dashboard Cite

Section: █ Conclusionsupporting

confidence: 72%

“…Scale (GCS) score of 8 and over and non-dominant hemisphere infarcts, that are operated on within the first 48 hours (4,5,7,14). Decompressive hemicraniectomy in patients not suitable for surgery increases the number of cases in a persistent vegetative state (15).…”

mentioning

confidence: 99%

Decompressive hemicraniectomy for malignant middle cerebral artery infarct

Gülensoy

Karatay²,

Yavuz³

et al. 2014

Turkish Neurosurgery

View full text Add to dashboard Cite

“…14,[16][17][18] Wagner et al 14 reported that 41% of patients had surgical complications, such as the appearance of hemorrhages (parenchymal, subdural, or epidural). These bleeds were more frequently found in patients who received smaller craniectomies and these bleeds were significantly related to an increased risk of mortality.…”

mentioning

confidence: 99%

Newly Suggested Surgical Method of Decompressive Craniectomy for Patients With Middle Cerebral Artery Infarction

et al. 2011

View full text Add to dashboard Cite

Objectives:The purpose of this study is to suggest the landmarks for decompressive craniectomy so that surgery can be standardized to achieve adequate decompression in patients with malignant middle cerebral artery infarction. We also analyzed the efficacy and safety of this newly suggested surgical method. Methods:Eleven patients (group A) underwent this newly suggested decompressive surgery. The bony landmarks for decompressive craniectomy are described. The area of the bone flap and the brain volume protruding out of the skull surface were measured. The outcomes were evaluated 3 months after the surgery. All the results were compared with that of 13 patients (group B) who were treated with conventional surgical methods.

show abstract

“…MMCAI is a potentially lethal clinical condition with poor outcomes and a mortality rate of approximately 80% without surgical treatment (1)(2)(3)(4). Decompressive craniectomy (DC) is increasingly being performed in patients with malignant brain ischemia to avoid the harmful consequences of cerebral edema and increase in the intracranial pressure (5)(6)(7), and this procedure has been consistently associated with a decrease in the mortality rate to approximately 30% (8)(9)(10)(11). DC is recommended for patients with MMCAI in the Japanese stroke guideline (grade A) (12), although the outcomes remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Functional Outcomes of Decompressive Craniectomy in Patients with Malignant Middle Cerebral Artery Infarction and Their Association with Preoperative Thalamus Deformation: An Analysis of 12 Patients

et al. 2016

View full text Add to dashboard Cite

Objective Decompressive craniectomy (DC) in patients with malignant middle cerebral artery (MCA) infarction is known to decrease the mortality rate. However, the functional outcomes (communication and oral intake) of this procedure remain unclear. Most patients with malignant MCA infarction exhibit a loss of consciousness, which may be principally governed by the thalamus. We herein investigated the functional outcomes of DC at 90 days after the onset of malignant MCA infarction and their association with preoperative thalamus deformation, which can occur due to pressure and edema. Methods Twelve of 2,692 patients with acute cerebral infarction were diagnosed with malignant MCA infarction and underwent DC. We evaluated preoperative thalamus damage using brain computed tomography and its association with communication and oral intake abilities and the modified Rankin Scale (mRS) and Barthel index scores at 90 days after stroke onset. Results The mRS score at 90 days was 0-4 in five patients. Seven patients could communicate immediately after surgery, while five could do so by 90 days. Five patients were able to resume the oral intake of food at 90 days. All patients with preoperative thalamus deformation showed a poor recovery, while those with absent or slight preoperative thalamus deformation showed a good recovery. Conclusion Patients with preoperative thalamus deformation caused by pressure and edema show a poor oral intake and communication abilities after DC, suggesting that preoperative thalamus deformation is a predictor of poor functional outcomes after DC in patients with malignant MCA infarction.

show abstract

Decompressive hemicraniectomy in malignant middle cerebral artery infarction: an analysis of long-term outcome and factors in patient selection

Cited by 81 publications

References 20 publications

Decompressive hemicraniectomy for malignant middle cerebral artery infarct

Decompressive hemicraniectomy for malignant middle cerebral artery infarct

Newly Suggested Surgical Method of Decompressive Craniectomy for Patients With Middle Cerebral Artery Infarction

Functional Outcomes of Decompressive Craniectomy in Patients with Malignant Middle Cerebral Artery Infarction and Their Association with Preoperative Thalamus Deformation: An Analysis of 12 Patients

Contact Info

Product

Resources

About