Outcome of decompressive craniectomy in comparison to nonsurgical treatment in patients with malignant MCA infarction

Rahmanian, Abdolkarim; Seifzadeh, Babak; Razmkon, Ali; Petramfar, Peyman; Kivelev, Juri; Alibai, Ehsanali; Hernesniemi, Juha

doi:10.1186/2193-1801-3-115

Cited by 22 publications

(12 citation statements)

References 34 publications

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“…An increase in the size of ICH on image studies is also an indication for surgical removal. Decompression could provide an enlargement of the intracranial space, preventing further rise of ICP and cerebral herniation 8). A craniectomy of greater than 8 cm may be large enough, but to obtain a real decompression, most authors recommend a minimum diameter of 12 cm.…”

Section: Discussionmentioning

confidence: 99%

A Faster and Wider Skin Incision Technique for Decompressive Craniectomy: n-Shaped Incision for Decompressive Craniectomy

Yang

Hyun

Oh³

et al. 2016

Korean J Neurotrauma

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ObjectiveDecompressive craniectomy (DC) is a useful surgical method to achieve adequate decompression in hypertensive intracranial patients. This study suggested a new skin incision for DC, and analyzed its efficacy and safety.MethodsIn the retrograde reviews, 15 patients underwent a newly suggested surgical approach using n-shape skin incision technique (Group A) and 23 patients were treated with conventional question mark skin incision technique (Group B). Two groups were compared in the terms of the decompressed area of the craniectomy, protruded brain volume out of the skull layer, the operation time from skin incision to bone flap removal, and modified Rankin Scale (mRS) which was evaluated for 3 months after surgery.ResultsThe decompressed area of craniectomy (389.1 cm2 vs. 318.7 cm2, p=0.041) and the protruded brain volume (151.8 cm3 vs. 116.2 cm3, p=0.045) were significantly larger in Group A compared to the area and the volume in Group B. The time interval between skin incision and bone flap removal was much shorter in Group A (23.3 minutes vs. 29.5 minutes, p=0.013). But, the clinical results were similar between 2 groups. Group A showed more favorable outcome proportion (mRS 0-3, 6/15 patients vs. 5/23 patients, p=0.225) and lesser mortality cases proportion 1/15 patients vs. 4/23 patients, but these differences were not significantly observed (p=0.225 and 0.339).ConclusionDC using n-shaped skin incision was a feasible and safe surgical technique. It may be an easier and faster method for the purpose of training neurosurgeons.

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Section: Discussionmentioning

confidence: 99%

A Faster and Wider Skin Incision Technique for Decompressive Craniectomy: n-Shaped Incision for Decompressive Craniectomy

Yang

Hyun

Oh³

et al. 2016

Korean J Neurotrauma

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“…Decompressive hemi-craniotomy is a possible lifesaving option which can decrease the mortality rates from 80 to 30% [13,14].…”

Section: Discussionmentioning

confidence: 99%

Malignant Middle Cerebral Artery Infarction Secondary to Traumatic Bilateral Internal Carotid Artery Dissection. A Case Report

Bajkó

Bălaşa

Moţăţăianu

et al. 2016

The Journal of Critical Care Medicine

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Traumatic bilateral dissection of the carotid arteries is a rare condition with potentially life-threatening complications. The case of a 57-year-old male patient with acute onset left sided hemiparesis, twelve hours after a blunt head injury, caused by a horse kick, is reported. A cerebral CT scan revealed right middle cerebral artery (MCA) territory infarction. Based on Duplex ultrasound and Angio CT scan findings, a diagnosis of bilateral ICA dissection was established. Despite antithrombotic treatment, the patient presented with a progressive worsening of his neurological status. The control CT scan evidenced malignant right MCA territory infarction that required decompressive craniotomy. The patient was discharged with significant neurological deficits. Together with this case, the aetiologies, clinical manifestations, diagnostic and therapeutical options and outcome of carotid artery dissection are discussed.

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“…1). Fourteen of them were finally included to the meta-analysis, including eight RCT [14][15][16][17][18][19][20][21] and six retrospective cohort studies [22][23][24][25][26][27]. The 423 DC cases and 389 conservative managed cases were involved.…”

Section: Search Results: An Assessment Of Risk Of Biasmentioning

confidence: 99%

Decompressive craniectomy for malignant middle cerebral artery infarctions: a meta-analysis

Xu¹,

Lu²,

Xue³

et al. 2017

Chin Neurosurg Jl

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Background: Decompressive craniectomy (DC) has been the classical management for malignant middle cerebral artery infarctions (mMCAI) in clinical practice. However, the association between DC and mMCAI remains unclear. This review went to evaluate the efficacy of DC in treating mMCAI patients. Methods: Studies were entirely searched since the foundation dates of multiple databases to June 2016. All major databases were involved, including Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and other sources. the bias risk of studies involved were evaluated. Modified Rankin Scale was defined as Primary outcome, Odds Ratio and 95% confidence intervals was taken as measurements. T2 (tau-squared) test, I2 test, and chi-square tests were used for statistical heterogeneity evaluation for each meta-analysis result, followed by fixed-effect model. Mantel-haenszel method was used in the process of summary estimations. All of the meta-analysis was conducted by Review Manager 5.3. Results & Conclusion: One thousand one hundred forty-five records of data were critically identified and collected through databases and 14 studies were finally involved. Result suggested that DC can ameliorate the suboptimal outcome of mMCAI patients.

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Outcome of decompressive craniectomy in comparison to nonsurgical treatment in patients with malignant MCA infarction

Cited by 22 publications

References 34 publications

A Faster and Wider Skin Incision Technique for Decompressive Craniectomy: n-Shaped Incision for Decompressive Craniectomy

A Faster and Wider Skin Incision Technique for Decompressive Craniectomy: n-Shaped Incision for Decompressive Craniectomy

Malignant Middle Cerebral Artery Infarction Secondary to Traumatic Bilateral Internal Carotid Artery Dissection. A Case Report

Decompressive craniectomy for malignant middle cerebral artery infarctions: a meta-analysis

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