Where are We Now with Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Infarction?.
10.7461/jcen.2013.15.2.61
- Author:
Jaechan PARK
1
;
Jeong Hyun HWANG
Author Information
1. Department of Neurosurgery, Cardiocerebrovascular Center, Kyungpook National University, Daegu, Republic of Korea. jparkmd@hotmail.com
- Publication Type:Controlled Clinical Trial ; Review
- Keywords:
Brain edema;
Cerebral infarction;
Decompressive surgery;
Middle cerebral artery
- MeSH:
Brain Edema;
Cerebral Infarction;
Decompression, Surgical;
Incidence;
Infarction;
Middle Cerebral Artery
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2013;15(2):61-66
- CountryRepublic of Korea
- Language:English
-
Abstract:
In spite of the best medical treatment, large hemispheric infarction, resulting from acute occlusion of either the internal carotid or the proximal middle cerebral artery with insufficient collateral blood flow is associated with a high case fatality rate of approximately 60%. Thus, a decompressive hemicraniectomy is considered a life-saving procedure for this devastating disease. Findings of three recent randomized, controlled clinical trials and their meta-analysis showed that early surgical decompression not only reduced the number of case fatalities but also increased the incidence of favorable outcomes. The authors review the pathophysiology, historical background in previous studies, operative timing, surgical technique and clinical outcomes of surgical decompression for malignant hemispheric infarction.
