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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Hemicraniectomy for malignant middle cerebral artery infarction
Martin Köhrmann1, Stefan Schwab
1Department of Neurology, University of Erlangen, Erlangen, Germany. martin.koehrmann@uk-erlangen.de
Current Opinion in Critical Care
|July 7, 2009
Summary
Decompressive hemicraniectomy significantly improves outcomes and saves lives in patients with malignant hemispheric infarction, a severe type of ischemic stroke. Randomized controlled trials now provide strong evidence for this life-saving surgical intervention.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Malignant hemispheric infarction is a severe form of ischemic stroke with high mortality.
- Decompressive hemicraniectomy has been proposed as a life-saving treatment based on case series.
- Randomized controlled trials were lacking to confirm its efficacy.
Purpose of the Study:
- To review the evidence for decompressive hemicraniectomy in malignant hemispheric infarction.
- To assess the life-saving potential of this surgical intervention.
Main Methods:
- Pooled analysis of three European randomized controlled trials.
- Individual data analysis from two of these trials.
Main Results:
- Compelling evidence demonstrates the benefit of decompressive hemicraniectomy.
- The procedure is proven to be life-saving for malignant hemispheric infarction.
Conclusions:
- The benefit and life-saving nature of hemicraniectomy for malignant hemispheric infarction are established.
- Future research should address optimal surgical timing and age limits for the procedure.
