Factors predictive of fatality in massive middle cerebral artery territory infarction and clinical experience of decompressive hemicraniectomy

K. W. Wang, W. N. Chang, J. T. Ho, H. W. Chang, C. C. Lui, M. H. Cheng, K. S. Hung, H. C. Wang, N. W. Tsai, T. K. Sun, C. H. Lu

研究成果: 雜誌貢獻文章

36 引文 斯高帕斯(Scopus)

摘要

To determine the factors predictive of fatality in massive middle cerebral artery (MCA) territory infarction and outcome of decompressive hemicraniectomy, 62 patients who were retrospectively verified with first event massive MCA infarctions were enrolled in this study. Amongst them, 21 received decompressive hemicraniectomy during hospitalization. Clinical data between early and late hemicraniectomy groups were also compared. Significant deterioration occurred in 40 cases, 21 of whom received decompressive hemicraniectomy. The other 19 received conservative treatment. The mortality rate of these 40 cases between decompressive hemicraniectomy and conservative treatment was 29% (six of 21) and 42% (eight of 19), respectively. Factors that predicted fatalities in our massive MCA infarction patients with or without decompressive hemicraniectomy were total scores of baseline GCS at the time of admission, associated with coronary artery diseases, and significant deterioration during hospitalization. This study confirms the life-saving procedure of hemicraniectomy that prevents death in patients deteriorating because of cerebral edema after infarction, although it may produce severe disability with an unacceptably poor quality of life in survival. Despite high mortality and morbidity, decompressive hemicraniectomy to prevent cerebral herniation when significant deterioration is demonstrated are essential for maximizing the potential for survival.

原文英語
頁(從 - 到)765-771
頁數7
期刊European Journal of Neurology
13
發行號7
DOIs
出版狀態已發佈 - 七月 2006
對外發佈Yes

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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    Wang, K. W., Chang, W. N., Ho, J. T., Chang, H. W., Lui, C. C., Cheng, M. H., Hung, K. S., Wang, H. C., Tsai, N. W., Sun, T. K., & Lu, C. H. (2006). Factors predictive of fatality in massive middle cerebral artery territory infarction and clinical experience of decompressive hemicraniectomy. European Journal of Neurology, 13(7), 765-771. https://doi.org/10.1111/j.1468-1331.2006.01365.x