Turkish Neurosurgery 2016 , Vol 26 , Num 5
Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Infarct
Bulent GULENSOY, Mete KARATAY, Yavuz ERDEM, Haydar CELIK, Tuncer TASCIOGLU, Idris SERTBAS, Tansu GURSOY, Halil KUL, Cevdet GOKCEK, Ugur YASITLI, Mehmet Akif BAYAR
Ankara Training and Research Hospital, Neurosurgery Clinic, Ankara, Turkey DOI : 10.5137/1019-5149.JTN.13241-14.1 AIM: Decompressive hemicraniectomy for a malignant middle cerebral artery infarct can be a life-saving surgical treatment. We aimed to investigate the surgical treatment results in cases that underwent decompressive hemicraniectomy for a malignant middle cerebral artery infarct in this study.

MATERIAL and METHODS: The clinical condition, radiological findings and surgical treatment results of 42 cases that underwent decompressive hemicraniectomy for a malignant middle cerebral artery infarct were retrospectively evaluated in this study.

RESULTS: There were 19 males and 23 females. The age range was 27 to 78 years with a mean age of 57.6 years. The infarct area was the non-dominant hemisphere in 20 cases and the dominant hemisphere in 22 cases. Preoperative Glasgow coma scale (GCS) scores were 5 to 12. The 42 cases with a malignant middle cerebral artery infarct were divided into 2 groups according to the Glasgow outcome scale (GOS) as the unfavorable outcome group (Group 1) with a score of 1 to 3 and the favorable outcome group with a score of 4 to 5 (Group 2). There were 27 cases in Group 1 and 15 in Group 2. There was a statistically significant association between a good result and age, Glasgow coma scale at the time of surgery, duration until surgery, and non-dominant hemisphere involvement. All cases with a Glasgow coma scale score of 7 or below had a poor outcome.

CONCLUSION: Decompressive hemicraniectomy in malignant middle cerebral artery infarct can be a life-saving procedure but is not useful in cases with a Glasgow coma scale score of 7 and below. Keywords : Malignant middle cerebral artery infarct, Decompressive hemicraniectomy, Glasgow outcome scale

Corresponding author : Mete Karatay, lexel26@hotmail.com