Abstract | OBJECTIVE: METHODS: Between February 2008 and October 2011, 131 patients were diagnosed with malignant MCA infarctions. We divided these patients into two groups: patients who underwent decompressive craniectomy (n = 58) and those who underwent conservative care (n = 73). A cut-off point of 70 years of age was set, and the study population was segregated into those who fell above or below this point. Mortality rates and functional outcome scores were assessed, and a modified Rankin Scale (mRS) score of > 3 was considered to represent a poor outcome. RESULTS: Mortality rates were significantly lower at 29.3% (one-month mortality rate) and 48.3% (six-month mortality rate) in the craniectomy group as compared to 58.9% and 71.2%, respectively, in the conservative care group (p < 0.001, p = 0.007). Age (≥70 years vs. < 70 years) did not statistically differ between groups for the six-month mortality rate (p = 0.137). However, the pre-operative National Institutes of Health Stroke Scale (NIHSS) score did contribute to the six-month mortality rate (p = 0.047). CONCLUSION:
Decompressive craniectomy is effective for patients with a malignant MCA infarction regardless of their age. Therefore, factors other than age should be considered and the treatment should be individualized in elderly patients with malignant infarctions.
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Authors | Jae Won Yu, Jae-Hyung Choi, Dae-Hyun Kim, Jae-Kwan Cha, Jae-Taeck Huh |
Journal | Journal of cerebrovascular and endovascular neurosurgery
(J Cerebrovasc Endovasc Neurosurg)
Vol. 14
Issue 2
Pg. 65-74
(Jun 2012)
ISSN: 2234-8565 [Print] Korea (South) |
PMID | 23210030
(Publication Type: Journal Article)
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