| Decompressive hemicraniectomy in ischaemic stroke. | |
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MedLine Citation:
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PMID: 20496283 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Hemispheric ischaemic stroke complicated by oedema is associated with high mortality. The results of randomized studies showed that decompressive hemicraniectomy performed in this group of patients could be beneficial. First experiences with implementation of hemi-craniectomy in patients with brain infarct in our stroke centre are presented. MATERIAL AND METHODS: Between August 2007 and July 2008, four patients with hemispheric brain infarcts complicated by malignant oedema underwent decompressive hemicraniectomy within 72 hours from symptoms onset. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Clinical outcome was assessed 3, 6 and 12 months after the event using the modified Rankin scale (mRS). RESULTS: In the first patient, the neurosurgical procedure included only decompressive hemicraniectomy, whereas in the other three duraplasty was performed additionally. The first patient died 23 days after the stroke onset due to acute respiratory failure. Another died at four months after the event, due to infectious complications. The remaining two patients presented severe functional disability 12 months after the procedure (mRS score 4). CONCLUSIONS: Decompressive surgery with duraplasty can be a life-saving procedure for patients with brain oedema. To our knowledge, the presented cases are among the first reported cases of hemispheric ischaemic stroke treated with decompressive hemicraniectomy in Poland. Extended follow-up with a larger group of patients is necessary to assess long-term outcome. |
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Authors:
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Maciej Swiat; Magdalena Targosz-Gajniak; Michał Arkuszewski; Maciej Wojtacha; Piotr Bazowski; Grzegorz Opala; Małgorzata Pieta; Jacek Gamrot |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurologia i neurochirurgia polska Volume: 44 ISSN: 0028-3843 ISO Abbreviation: Neurol. Neurochir. Pol. Publication Date: 2010 Mar-Apr |
Date Detail:
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Created Date: 2010-05-24 Completed Date: 2010-07-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0101265 Medline TA: Neurol Neurochir Pol Country: Poland |
Other Details:
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Languages: eng Pagination: 131-8 Citation Subset: IM |
Affiliation:
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Klinika Neurologii Wieku Podeszlego, Slaski Uniwersytet Medyczny w Katowicach, SP Centralny Szpital Kliniczny w Katowicach. mswiat@csk.katowice.pl |
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| MeSH Terms | |
Descriptor/Qualifier:
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Brain Edema
/
etiology,
surgery* Brain Ischemia / complications, surgery* Craniotomy / methods* Decompression, Surgical / methods* Female Follow-Up Studies Humans Infarction, Middle Cerebral Artery / surgery* Male Middle Aged Neurosurgical Procedures / methods Poland Treatment Outcome |
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