Decompressive craniectomy for the treatment of malignant middle cerebral artery infarction.
Kapil Mohan RajwaniMatthew CrockerBarry MoynihanPublished in: British journal of neurosurgery (2017)
In patients 60 years of age or younger, DC within 48 hours of stroke onset significantly reduced risk of death and major disability (mRS >3) compared to maximal medical therapy only. In older patients (>60 years) DC also significantly improved survival but the majority of survivors were left with major disability (mRS 4-5). DC performed more than 48 hours after symptom onset does not appear to be superior to best medical management. The decision to perform decompressive surgery needs to be made on a case-by-case basis, taking into account the degree of disability patients and their carers are willing to accept.
Keyphrases
- end stage renal disease
- middle cerebral artery
- multiple sclerosis
- ejection fraction
- newly diagnosed
- chronic kidney disease
- dendritic cells
- peritoneal dialysis
- prognostic factors
- stem cells
- minimally invasive
- severe traumatic brain injury
- blood pressure
- young adults
- coronary artery disease
- patient reported
- heart rate
- cell therapy
- high intensity
- smoking cessation