Outcome following decompressive hemicraniectomy in malignant middle cerebral artery infarct: Does age matters?

摘要

Space occupying, malignant middle cerebral artery infarct (mMCAI) accounts for 1% and 10% of all supratentorial ischemic strokes [1],[2],[3] and is associated with about 80% case fatality rate in intensive care-based series. [4],[5] Often no medical treatment is effective in these patients. [6] Decompressive hemicraniectomy (DHC) with duroplasty is now an option for clinical management of mMCAI. [7],[8] Hemicraniectomy involves removal of a large part of cranium and this provides space to enable outward swelling of ischemic brain tissue, [9],[10] and decrease in intracranial pressure and improvement in brain tissue oxygenation and these changes occur to a greater extent after opening the dura. [11]