Decompressive hemicraniectomy in ischaemic stroke
| Autor: | Piotr Bazowski, Gamrot J, Michal Arkuszewski, Magdalena Targosz-Gajniak, Maciej Świat, Grzegorz Opala, Maciej Wojtacha, Małgorzata Pięta |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Stroke severity Brain Edema Neurosurgical Procedures Brain Ischemia Modified Rankin Scale Ischaemic stroke medicine Humans In patient cardiovascular diseases Stroke Decompressive hemicraniectomy business.industry Stroke scale Infarction Middle Cerebral Artery Middle Aged Decompression Surgical medicine.disease Surgery Neurosurgical Procedure Treatment Outcome Anesthesia Female Poland Neurology (clinical) business Craniotomy Follow-Up Studies |
| Zdroj: | Neurologia i Neurochirurgia Polska. 44:131-138 |
| ISSN: | 0028-3843 |
| DOI: | 10.1016/s0028-3843(14)60004-9 |
| Popis: | 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 hemicraniectomy 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. |
| Databáze: | OpenAIRE |
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