Decompressive Hemicraniectomy for Middle Cerebral Artery Stroke: Indications and Perioperative Care
| Autor: | Marissa Boyce, Beth Karasin, Monica Grzelak, Lauren Eskuchen, Johanna Watkinson, Tara Hardinge, Gina Rizzo |
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| Rok vydání: | 2020 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Decompressive Craniectomy Perioperative Care Cerebral edema 03 medical and health sciences 0302 clinical medicine Quality of life Medicine Humans Medical history 030212 general & internal medicine Intensive care medicine Stroke 030504 nursing business.industry Infarction Middle Cerebral Artery Emergency department Perioperative medicine.disease Medical–Surgical Nursing Treatment Outcome Quality of Life Female Presentation (obstetrics) Middle cerebral artery stroke 0305 other medical science business |
| Zdroj: | AORN journalReferences. 114(1) |
| ISSN: | 1878-0369 |
| Popis: | Decompressive hemicraniectomy (DHC) is a procedure performed in the setting of malignant cerebral edema after a large middle cerebral artery stroke. The decision to proceed with surgical decompression is one that must be made judiciously and rapidly. Although this can be a life-saving surgery, it does not necessarily improve the patient's quality of life. The neurosurgical team must thoroughly discuss the patient's comorbidities, age, dominant versus nondominant hemispheric injury, and neurological expectations, and the procedure itself (ie, risks, benefits, expected postoperative course, goals of care) with the patient and his or her family before DHC. This article briefly reviews the anatomy of the brain and stroke presentation and provides an overview of DHC and the perioperative course. The article concludes with a case study of a patient with a medical history of hypertension and prediabetes who presents to the emergency department after a fall and undergoes an emergent DHC. |
| Databáze: | OpenAIRE |
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