Is decompressive craniectomy for malignant middle cerebral artery infarction of any worth? / 浙江大学学报(英文版)(B辑:生物医学和生物技术)
Journal of Zhejiang University. Science. B
; (12): 644-649, 2005.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-249156
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>Malignant middle cerebral artery (MCA) infarction is characterized by mortality rate of up to 80%. The aim of this study was to determine the value of decompressive craniectomy in patients presenting malignant MCA infarction compared with those receiving medical treatment alone.</p><p><b>METHODS</b>Patients with malignant MCA infarction treated in our hospital between January 1996 and March 2004 were included in this retrospective analysis. The National Institute of Health Stroke Scale (NIHSS) was used to assess neurological status on admission and at one week after surgery. All patients were followed up for assessment of functional outcome by the Barthel index (BI) and modified Rankin Scale (RS) at 3 months after infarction.</p><p><b>RESULTS</b>Ten out of 24 patients underwent decompressive craniectomy. The mean interval between stroke onset and surgery was 62.10 h. The mortality was 10.0% compared with 64.2% in patients who received medical treatment alone (P<0.001). The mean NIHSS score before surgery was 26.0 and 15.4 after surgery (P<0.001). At follow up, patients who underwent surgery had significantly better outcome with mean BI of 53.3, RS of 3.3 as compared to only 16.0 and 4.60 in medically treated patients. Speech function also improved in patients with dominant hemispherical infarction.</p><p><b>CONCLUSION</b>Decompressive craniectomy in patients with malignant MCA infarction improves both survival rates and functional outcomes compared with medical treatment alone. A randomized controlled trial is required to substantiate those findings.</p>
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Cardiovascular
/
Doença Cerebrovascular
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Cirurgia Geral
/
Índice de Gravidade de Doença
/
Estudos Retrospectivos
/
Resultado do Tratamento
/
Descompressão Cirúrgica
/
Recuperação de Função Fisiológica
/
Craniotomia
/
Infarto da Artéria Cerebral Média
/
Diagnóstico
/
Métodos
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
Limite:
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Journal of Zhejiang University. Science. B
Ano de publicação:
2005
Tipo de documento:
Artigo