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Received: 2004-08-20

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Journal of Zhejiang University SCIENCE B 2005 Vol.6 No.7 P.644-649


Is decompressive craniectomy for malignant middle cerebral artery infarction of any worth?

Author(s):  YANG Xiao-feng, YAO Yu, HU Wei-wei, LI Gu, XU Jin-fang, ZHAO Xue-qun, LIU Wei-guo

Affiliation(s):  Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

Corresponding email(s):   yu_yao03@126.com

Key Words:  Decompressive craniectomy, Cerebral infarction, Middle cerebral artery (MCA)

YANG Xiao-feng, YAO Yu, HU Wei-wei, LI Gu, XU Jin-fang, ZHAO Xue-qun, LIU Wei-guo. Is decompressive craniectomy for malignant middle cerebral artery infarction of any worth?[J]. Journal of Zhejiang University Science B, 2005, 6(7): 644-649.

@article{title="Is decompressive craniectomy for malignant middle cerebral artery infarction of any worth?",
author="YANG Xiao-feng, YAO Yu, HU Wei-wei, LI Gu, XU Jin-fang, ZHAO Xue-qun, LIU Wei-guo",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Is decompressive craniectomy for malignant middle cerebral artery infarction of any worth?
%A YANG Xiao-feng
%A HU Wei-wei
%A LI Gu
%A XU Jin-fang
%A ZHAO Xue-qun
%A LIU Wei-guo
%J Journal of Zhejiang University SCIENCE B
%V 6
%N 7
%P 644-649
%@ 1673-1581
%D 2005
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2005.B0644

T1 - Is decompressive craniectomy for malignant middle cerebral artery infarction of any worth?
A1 - YANG Xiao-feng
A1 - YAO Yu
A1 - HU Wei-wei
A1 - LI Gu
A1 - XU Jin-fang
A1 - ZHAO Xue-qun
A1 - LIU Wei-guo
J0 - Journal of Zhejiang University Science B
VL - 6
IS - 7
SP - 644
EP - 649
%@ 1673-1581
Y1 - 2005
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2005.B0644

Objective: 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. Methods: 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. Results: 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. Conclusion: 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.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


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