Decompressive Craniotomy for Malignant Middle Cerebral Artery Infarction: Optimal Timing and Literature Review

Elsawaf, Ahmed; Galhom, Ayman

doi:10.1016/j.wneu.2018.04.005

Cited by 26 publications

(15 citation statements)

References 17 publications

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“…A previous study by Ahamed Elsawaf et al showed that decompression craniotomy within 6 hours of onset without waiting for neurological worsening has a significant impact on prognosis. 10…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Risk Factors of Massive Middle Cerebral Artery Infarction in a Tertiary Care Centre in Central Tamilnadu

Thangaraj¹,

Palliyali²

2019

IJCMR

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Introduction: Large territory middle cerebral artery strokes are devastating events that result in high rates of disability and death. Nearly half of all stroke survivors never regain functional independence. Current research aimed to study the clinical profile and risk factors of massive middle cerebral artery (MCA) infarction and to study the relation of alcoholism and its pattern to massive MCA stroke. Material and methods: Patients admitted with massive MCA infarct with an early ischemic change on CT affecting at least >50% of the MCA territory within 48 hours of symptom onset were included in the study. Stroke mimics and those with history of previous stroke were excluded. Study design was a cross sectional, observational study. Results: A total of 60 cases were analyzed. Mean age was 55.4. 35% subjects had NIHSS >20.Diabetes was present in 18. Total of 60% were alcoholics, and 83% of males were alcoholics.31 subjects were heavy drinkers. Binge drinking was present in 30%.Mean duration of alcohol was 9.5 years. Average intake per day was 120 ml. Mean ASPECT score in the subjects was 3. 25 patients had a MRS 4 at discharge. Craniotomy done in 6 cases. Total death were 17(29%). Aspiration pneumonia was the common cause of death (5). Conclusion: NIHSS 20 or more was associated with adverse outcome (P value <0.05).60% were alcoholics. Binge intake in 30%(associated with adverse outcome P value <0.05). Mean Aspect score was 3 (3 or less associated with adverse outcome P value <0.05).

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“…A previous study by Ahamed Elsawaf et al showed that decompression craniotomy within 6 hours of onset without waiting for neurological worsening has a significant impact on prognosis. 10…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Risk Factors of Massive Middle Cerebral Artery Infarction in a Tertiary Care Centre in Central Tamilnadu

Thangaraj¹,

Palliyali²

2019

IJCMR

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“…Three linear measurements were utilized in the analysis [40,41]. First, the ideal midline was drawn for reference in the axial (IML; Fig.…”

Section: Midline Shift Analysismentioning

confidence: 99%

“…Measurements of MLS were conducted in the axial plane ( Fig. 1b), more commonly utilized in human clinical literature [40,41], as well as the coronal plane (Fig. 1c).…”

Section: Acute Midline Shift Is Highly Correlated With Chronic Functimentioning

confidence: 99%

Neural Stem Cell Extracellular Vesicles Disrupt Midline Shift Predictive Outcomes in Porcine Ischemic Stroke Model

Spellicy

Kaiser

Bowler

et al. 2019

Transl. Stroke Res.

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Magnetic resonance imaging (MRI) is a clinically relevant non-invasive imaging tool commonly utilized to assess stroke progression in real time. This study investigated the utility of MRI as a predictive measure of clinical and functional outcomes when a stroke intervention is withheld or provided, in order to identify biomarkers for stroke functional outcome under these conditions. Fifteen MRI and ninety functional parameters were measured in a middle cerebral artery occlusion (MCAO) porcine ischemic stroke model. Multiparametric analysis of correlations between MRI measurements and functional outcome was conducted. Acute axial and coronal midline shift (MLS) at 24 h post-stroke were associated with decreased survival and recovery measured by modified Rankin scale (mRS) and were significantly correlated with 52 measured acute (day 1 post) and chronic (day 84 post) gait and behavior impairments in non-treated stroked animals. These results suggest that MLS may be an important non-invasive biomarker that can be used to predict patient outcomes and prognosis as well as guide therapeutic intervention and rehabilitation in non-treated animals and potentially human patients that do not receive interventional treatments. Neural stem cell-derived extracellular vesicle (NSC EV) was a disruptive therapy because NSC EVadministration post-stroke disrupted MLS correlations observed in non-treated stroked animals. MLS was not associated with survival and functional outcomes in NSC EV-treated animals. In contrast to untreated animals, NSC EVs improved stroked animal outcomes regardless of MLS severity.

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“…Область применения этих операций расширяется. Они с успехом используются при тяжелой черепномозговой травме, обширных инфарктах средней мозговой артерии и др., когда имеет место острый, выраженный дислокационный синдром [145][146][147].…”

Section: внутрижелудочковые кровоизлиянияunclassified

Recommended algorithms for surgical treatment of non-traumatic intracerebral haematoma

Dzenis¹

2018

Ukr Neurosurg J

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Decompressive Craniotomy for Malignant Middle Cerebral Artery Infarction: Optimal Timing and Literature Review

Cited by 26 publications

References 17 publications

Clinical Profile and Risk Factors of Massive Middle Cerebral Artery Infarction in a Tertiary Care Centre in Central Tamilnadu

Clinical Profile and Risk Factors of Massive Middle Cerebral Artery Infarction in a Tertiary Care Centre in Central Tamilnadu

Neural Stem Cell Extracellular Vesicles Disrupt Midline Shift Predictive Outcomes in Porcine Ischemic Stroke Model

Recommended algorithms for surgical treatment of non-traumatic intracerebral haematoma

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