Decompressive craniotomy for the treatment of malignant infarction of the middle cerebral artery: mortality and outcome

• Published in: Arquivos de neuro-psiquiatria 2017-07, Vol.75 (7), p.424-428
• Main Authors: Bongiorni, Gianise Toboliski, Hockmuller, Marjeane Cristina Jaques, Klein, Cristini, Antunes, Ápio Cláudio Martins
• Format: Article
• Language: English
• Subjects: cerebral infarction; craniotomy; Cross-Sectional Studies; Decompressive Craniectomy - methods; Decompressive Craniectomy - mortality; Female; Humans; Infarction, Middle Cerebral Artery - mortality; Infarction, Middle Cerebral Artery - surgery; intracranial hypertension; Length of Stay; Male; Middle Aged; NEUROSCIENCES; PSYCHIATRY; Quality of Life; Retrospective Studies
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1590/0004-282X20170053

ABSTRACT Objective To assess, by Rankin scale, the functional disability of patients who had a malignant middle cerebral artery (MCA) ischemic stroke, who underwent decompressive craniotomy (DC) within the first 30 days. Methods A cross-sectional study in a University hospital. Between June 2007 and December 2014, we retrospectively analyzed the records of all patients submitted to DC due to a malignant MCA infarction. The mortality rate was defined during the hospitalization period. The modified outcome Rankin score (mRS) was measured 30 days after the procedure, for stratification of the quality of life. Results The DC mortality rate was 30% (95% CI 14.5 to 51.9) for the 20 patients reported. The mRS 30 days postoperatively was ≥ 4 [3.3 to 6] for all patients thereafter. Conclusion DC is to be considered a real alternative for the treatment of patients with a malignant ischemic MCA infarction.