Early Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Infarction in Asian Patients: A Single-Center Study

Paliwal, Prakash; Kazmi, Farasat; Teoh, Hock Luen; Yeo, Leonard Leong‐Litt; Seet, Raymond C.S.; Yeo, Tseng Tsai; Lwin, Sein; Chou, Ning; Tan, Teng Hwee; Chan, Bernard P.L.; Sharma, Vijay K.

doi:10.1016/j.wneu.2017.12.157

Cited by 11 publications

(22 citation statements)

References 39 publications

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“…In the studies related to patients who underwent decompression surgery due to MCA infarction, right MCA was more frequent than left side [1,13,18,21]. Paliwal et al stated that right MCA infarction rate was 70% [1]. In our study, righ MCA infarction rate was 64.3%.…”

Section: Discussionsupporting

confidence: 48%

“…Both in the study by Foerch et al [20] and our study, as well as the small number of patients is thought to result in the absence of an effect on the outcome of the surgical timing. Recently, 4 points in modified ranking scale has been considered favorable for evaluating survival of patients, but in the last period modified Rankin scale (mRS) ≤ 3 was considered more favorable [1]. In our study, mRS was 4 in 2 of 6 survivors, 5 was in 3, and 3 was in 1 patient.…”

Section: Discussionmentioning

confidence: 51%

“…Duraplasty with decompressive hemicraniectomy supports edema enlargement to the outside of the neurocranium and thereby, prevents lethal internal displacement and subsequent herniation of brain tissue. Decompressive hemicraniectomy is [1]. Both DECIMAL and DESTINY trials showed that for patients who were treated by surgery within 48 hours after symptoms start, early and long-term mortality rates were decreased and neurologic results improved [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, mRS was 4 in 2 of 6 survivors, 5 was in 3, and 3 was in 1 patient. In the studies related to patients who underwent decompression surgery due to MCA infarction, right MCA was more frequent than left side [1,13,18,21]. Paliwal et al stated that right MCA infarction rate was 70% [1].…”

Section: Discussionmentioning

confidence: 99%

“…Acute ischemic stroke is one of the destructive neurologic emergencies. Despite new therapies, about half of stroke patients have important morbidities, they need a long period of rehabilitation [1,2]. Life-threatening brain edema occurs between 2 and 5days after onset of stroke in 1-10% of supratentorial infarct patients [3].…”

Section: Introductionmentioning

confidence: 99%

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Prognosis of the decompressive craniectomy for stroke according to preoperative computed tomography

Güvenç¹

2019

Ann Clin Anal Med

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Aim: The aim of this study was to investigate the preoperative clinic and radiologic signs which affect the prognosis after decompressive craniectomy for stroke. Material and Method: We retrospectively analyzed the demographic and radiological images of patients who underwent decompressive craniectomy for internal carotid artery (ICA) and middle cerebral artery (MCA) strokes. Seventeen patients analyzed retrospectively between January 2012 and December 2015 at our hospital. Results: A total of 17 decompressive craniectomies were performed for supratentorial ischemic strokes: 3 (17.6%) ICA and 14 (82.4%) MCA stroke patients. There were 11 (64.7%) males and 6 (35.3%) females with a mean age of 59.35 ± 15.39 years (range 20-83 years). There were 10 (58.9%) mortalities. Seven patients were discharged home. The patients' Glasgow Coma Scale, infarct type, dominant hemisphere side, preoperative cranial tomography shift, hemorrhagic transformation, basal cistern, transcalvarial herniation were analyzed. Basal cisterns of 8 (47.1%) patients were open, of 9 (52.9%) patients were closed before decompressive craniectomy. There was a statistically significant difference between mortality rate between open cistern versus closed basal cistern (p=0.029). Discussion: In our study, open cisterns were associated with good outcomes. Larger studies should be performed in the the future.

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