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Functional Outcomes of Decompressive Hemicraniectomy for Treatment of Malignant Infarctions of the Middle Cerebral Artery 被引量:1
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作者 Amr Mohsen Waleed Abbass 《Open Journal of Modern Neurosurgery》 2020年第3期307-317,共11页
<strong>Introduction:</strong> Malignant middle cerebral artery (MCA) infarction is a devastating entity that is associated with up to 80% mortality. Decompressive Hemicraniectomy has been utilized to trea... <strong>Introduction:</strong> Malignant middle cerebral artery (MCA) infarction is a devastating entity that is associated with up to 80% mortality. Decompressive Hemicraniectomy has been utilized to treat brain swelling and mass effect secondary to these infarctions in an attempt to improve functional outcome. <strong>Aim: </strong>To evaluate the functional outcome of decompressive hemicraniectomy in management of malignant MCA infarctions. <strong>Methods: </strong>The study included 30 patients with malignant MCA infarctions operated upon by decompressive hemicraniectomy and duroplasty with pericranium or fascia lata graft in the period from June 2016 to January 2019. Pre-operative neurological condition, associated morbidity, location and extent of the infarction were assessed. Surgery was performed within 48 hours of the onset of stroke or 12 hours within deterioration of conscious level. Pre-operative CT scan as well as sequential post-operative CT was done. Functional outcome was assessed by the modified Rankin Scale (mRS) at the time of discharge and 3 months following surgery. <strong>Results: </strong>The study included 18 males and 12 females with a mean age of 54.7 years. The pre-operative GCS was <8 (5 - 7) in 11 patients and 8 or higher (8 - 13) in 19 patients. Good functional outcome (mRS 0 - 3) was achieved in 13 (43.3%) cases while poor outcome (mRS 4 - 5) occurred in 8 (26.7%) cases and mortality (mRS 6) occurred in 9 (30%) cases. <strong>Conclusion:</strong> Decompressive hemicraniectomy improves functional outcome in cases of malignant MCA infarction. Pre-operative GCS, age, volume of infarction, degree of midline shift, timing of surgery and associated morbidity are the most important factors affecting the outcome. 展开更多
关键词 Decompressive Hemicraniectomy malignant MCA infarction Functional Outcome Modified Rankin Scale
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Decompressive craniectomy for malignant middle cerebral artery infarctions: a meta-analysis
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作者 Long Xu Te Lu +4 位作者 Xiaogang Tao Dandan Wang Weiming Liu Jingsheng Li Baiyun Liu 《Chinese Neurosurgical Journal》 CSCD 2017年第3期142-149,共8页
Background: Decompressive craniectomy (DC) has been the classical management for malignant middle cerebral artery infarctions (mMCAI) in clinical practice. However, the association between DC and mMCAI remains unclear... Background: Decompressive craniectomy (DC) has been the classical management for malignant middle cerebral artery infarctions (mMCAI) in clinical practice. However, the association between DC and mMCAI remains unclear. This review went to evaluate the efficacy of DC in treating mMCAI patients. Methods: Studies were entirely searched since the foundation dates of multiple databases to June 2016. All major databases were involved, including Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and other sources. the bias risk of studies involved were evaluated. Modified Rankin Scale was defined as Primary outcome, Odds Ratio and 95% confidence intervals was taken as measurements. T2 (tau-squared) test, I2 test, and chi-square tests were used for statistical heterogeneity evaluation for each meta-analysis result, followed by fixed-effect model. Mantel-haenszel method was used in the process of summary estimations. All of the meta-analysis was conducted by Review Manager 5.3.Results & Conclusion: One thousand one hundred forty-five records of data were critically identified and collected through databases and 14 studies were finally involved. Result suggested that DC can ameliorate the suboptimal outcome of mMCAI patients. 展开更多
关键词 Decompressive craniectomy malignant middle cerebral artery infarction META-ANALYSIS
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Malignant middle-cerebral artery territory infarction in tuberculous vasculitis
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作者 Salvadeeswaran Meenakshi-Sundaram Sundararajan Srinivasan +3 位作者 Somalinga Nagendran Karthik Suresh Pandi Alagappan Periyakaruppan Bharathi Sundar 《Neuroimmunology and Neuroinflammation》 2014年第1期95-97,共3页
Intracranial large vessel involvement is an unusual complication of tuberculous meningitis.The authors report a 39-year-old female presenting with an episode of seizure,followed by rapid decline in sensorium without p... Intracranial large vessel involvement is an unusual complication of tuberculous meningitis.The authors report a 39-year-old female presenting with an episode of seizure,followed by rapid decline in sensorium without prominent systemic features.An initial cranial magnetic resonance imaging revealed tuberculomata and patchy infarcts.Despite antituberculous therapy,she progressively worsened.A cranial computed tomography scan done following the worsening revealed a massive middle-cerebral artery(MCA)infarct.Unfortunately,the patient died in spite of decompressive craniotomy.Malignant MCA territory infarct is a rare and potentially fatal complication of tuberculous meningitis. 展开更多
关键词 ARTERITIS malignant middle-cerebral artery territory infarct tuberculous meningitis
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