Department of Neurosurgery, Chang Gung University, Chang Gung Memorial Hospital, Keelung, Taiwan.
J Clin Neurosci. 2012 May;19(5):661-4. doi: 10.1016/j.jocn.2011.07.045. Epub 2012 Feb 28.
Decompressive hemicraniectomy (DC) can save the lives of patients with malignant middle cerebral artery (MCA) infarction. We proposed that postoperative midline shift is important for the long-term outcome of patients with MCA infarction. We conducted a retrospective study of DC in 38 patients with malignant MCA infarction. The long-term outcome was assessed one year after surgery using the modified Rankin Scale (mRS) score. Patients who had midline shift less than the optimal diagnostic cut-off point on the fourth postoperative day were classified as having a successful decompression and the remaining patients were classified in the failed decompression group. The successful decompression group mRS score was 4.20±0.89 one year after surgery and the failed decompression group mRS score was 5.11±0.76 (p<0.0001). Successful decompression, resulting in postoperative midline shift of less than 5mm, was a key factor for beneficial, long-term functional outcomes in patients with malignant MCA infarction.
去骨瓣减压术（DC）可以挽救恶性大脑中动脉（MCA）梗死患者的生命。我们提出，术后中线移位对于 MCA 梗死患者的长期预后很重要。我们对 38 例恶性 MCA 梗死患者进行了 DC 回顾性研究。术后第 4 天，使用改良 Rankin 量表（mRS）评分评估长期预后。术后第 4 天中线移位小于最佳诊断截止点的患者被分类为减压成功，其余患者被分类为减压失败。减压成功组 mRS 评分术后 1 年为 4.20±0.89，减压失败组 mRS 评分为 5.11±0.76（p<0.0001）。成功减压，即术后中线移位小于 5mm，是恶性 MCA 梗死患者获得有益、长期功能结局的关键因素。
