Related Experiment Video
Updated: Jul 20, 2026
10:25
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Factors predicting prognosis after decompressive hemicraniectomy for hemispheric infarction
A A Rabinstein1, N Mueller-Kronast, B V Maramattom
1Department of Neurology, University of Miami School of Medicine, Miami, FL, USA. rabinstein.alejandro@mayo.edu
Neurology
|September 13, 2006
Summary
Older age independently predicts poor outcomes following decompressive hemicraniectomy for hemispheric ischemic stroke. While hypertension history is a risk factor, thrombolysis shows a protective effect in stroke patients.
Area of Science:
- Neurosurgery
- Neurology
- Stroke Medicine
Background:
- Decompressive hemicraniectomy is a critical intervention for severe hemispheric ischemic stroke.
- Predicting outcomes after this procedure is essential for patient management and resource allocation.
Purpose of the Study:
- To identify predictors of functional outcome in patients undergoing decompressive hemicraniectomy for hemispheric ischemic stroke.
- To evaluate the impact of various clinical and demographic factors on recovery.
Main Methods:
- Retrospective review of 42 consecutive cases of decompressive hemicraniectomy.
- Univariate and multivariate analyses were performed to assess outcome predictors.
Main Results:
- Advanced age and a history of hypertension were associated with unfavorable outcomes.
- Thrombolysis was found to be a protective factor.
- Factors like infarct side, pupillary response, midline shift, and surgical timing did not predict outcome.
- Older age independently predicted poor recovery (OR 2.9 per 10-year increase).
Conclusions:
- Older age is a significant independent predictor of poor recovery after decompressive hemicraniectomy for ischemic stroke.
- While certain factors like hypertension increase risk, thrombolysis may improve outcomes.
Related Concept Videos
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...