Gulensoy Bulent, Karatay Mete, Erdem Yavuz, Celik Haydar, Tascioglu Tuncer, Sertbas Idris, Gursoy Tansu, Kul Halil, Gokcek Cevdet, Yasitli Ugur, Bayar Mehmet Akif
Ankara Training and Research Hospital, Neurosurgery Clinic, Ankara, Turkey.
Turk Neurosurg. 2016;26(5):704-8. doi: 10.5137/1019-5149.JTN.13241-14.1.
Decompressive hemicraniectomy for a malignant middle cerebral artery infarct can be a life-saving surgical treatment. We aimed to investigate the surgical treatment results in cases that underwent decompressive hemicraniectomy for a malignant middle cerebral artery infarct in this study.
The clinical condition, radiological findings and surgical treatment results of 42 cases that underwent decompressive hemicraniectomy for a malignant middle cerebral artery infarct were retrospectively evaluated in this study.
There were 19 males and 23 females. The age range was 27 to 78 years with a mean age of 57.6 years. The infarct area was the non-dominant hemisphere in 20 cases and the dominant hemisphere in 22 cases. Preoperative Glasgow coma scale (GCS) scores were 5 to 12. The 42 cases with a malignant middle cerebral artery infarct were divided into 2 groups according to the Glasgow outcome scale (GOS) as the unfavorable outcome group (Group 1) with a score of 1 to 3 and the favorable outcome group with a score of 4 to 5 (Group 2). There were 27 cases in Group 1 and 15 in Group 2. There was a statistically significant association between a good result and age, Glasgow coma scale at the time of surgery, duration until surgery, and non-dominant hemisphere involvement. All cases with a Glasgow coma scale score of 7 or below had a poor outcome.
Decompressive hemicraniectomy in malignant middle cerebral artery infarct can be a life-saving procedure but is not useful in cases with a Glasgow coma scale score of 7 and below.
减压性去骨瓣开颅术治疗大脑中动脉恶性梗死是一种挽救生命的外科治疗方法。本研究旨在探讨接受减压性去骨瓣开颅术治疗大脑中动脉恶性梗死患者的手术治疗结果。
本研究回顾性评估了42例接受减压性去骨瓣开颅术治疗大脑中动脉恶性梗死患者的临床情况、影像学表现及手术治疗结果。
男性19例，女性23例。年龄范围为27至78岁，平均年龄57.6岁。梗死部位在非优势半球20例，优势半球22例。术前格拉斯哥昏迷量表（GCS）评分为5至12分。42例大脑中动脉恶性梗死患者根据格拉斯哥预后量表（GOS）分为两组，即预后不良组（1组），评分为1至3分；预后良好组，评分为4至5分（2组）。1组27例，2组15例。良好结果与年龄、手术时的格拉斯哥昏迷量表评分、手术延迟时间及非优势半球受累之间存在统计学显著关联。所有格拉斯哥昏迷量表评分7分及以下的患者预后均较差。
减压性去骨瓣开颅术治疗大脑中动脉恶性梗死可能是一种挽救生命的手术，但对格拉斯哥昏迷量表评分7分及以下的患者无效。
