Decompressive Craniectomy for Malignant Middle Cerebral Infarction / 대한뇌혈관외과학회지
Korean Journal of Cerebrovascular Surgery
; : 49-54, 2009.
Article
in Korean
| WPRIM (Western Pacific)
| ID: wpr-39015
Responsible library:
WPRO
ABSTRACT
Decompressive craniectomy is used to treat increased intracranial pressure due to brain swelling in middle cerebral artery infarction. Recently, 3 European multicenter, prospective, randomized trials and a pooled analysis were published. In the pooled analysis, decompressive craniectomy did not appear to increase the risk of complete dependency, misery, and hopelessness. Exactly 2 patients in the surgical and medical groups (5%) were bedbound and severely disabled (mRS 5) at 1 year. The proportion of patients alive with minimal-tomoderate disability (mRS 0-3), however, was significantly increased from 21% to 43%. Decompressive craniectomy resulted in a 49% absolute risk reduction in death, and an absolute increase in the proportion of patients rated as mRS 2 of 12%, mRS 3 of 10%, and mRS 4 of 29%. But, this can be applied in cases with relative young age and early surgical procedure. Therefore, the indication for decompressive craniectomy should be individualized and its potential implications on long-term outcomes should be comprehensively discussed with the caregivers.
Full text:
Available
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Cerebrovascular Disease
Database:
WPRIM (Western Pacific)
Main subject:
Brain Edema
/
Intracranial Pressure
/
Cerebral Infarction
/
Caregivers
/
Intracranial Hypertension
/
Infarction, Middle Cerebral Artery
/
Dependency, Psychological
/
Decompressive Craniectomy
/
Numbers Needed To Treat
Type of study:
Controlled clinical trial
/
Etiology study
Limits:
Humans
Language:
Korean
Journal:
Korean Journal of Cerebrovascular Surgery
Year:
2009
Document type:
Article