Department of Neurosurgery, Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050, Australia.
J Clin Neurosci. 2011 Aug;18(8):1018-22. doi: 10.1016/j.jocn.2010.12.021. Epub 2011 May 17.
Malignant middle cerebral artery (MCA) infarction (MMI) is associated with a mortality rate of 80%. Decompressive craniectomy is considered a life-saving procedure for patients with this devastating condition. Preclinical and clinical data suggest that this procedure should be undertaken as early as possible, prompting increasing demand for emergency surgery. This article reviews the pathophysiology of MMI, and the experimental and clinical evidence supporting this procedure. We consider some of the controversies surrounding patient selection for this procedure and discuss the role of intracranial pressure monitoring in MMI.
恶性大脑中动脉（MCA）梗死（MMI）的死亡率为 80%。去骨瓣减压术被认为是治疗这种破坏性疾病的救命手术。临床前和临床数据表明，应尽早进行该手术，这促使对急诊手术的需求不断增加。本文综述了 MMI 的病理生理学，以及支持该手术的实验和临床证据。我们考虑了围绕该手术患者选择的一些争议，并讨论了颅内压监测在 MMI 中的作用。
