Decompressive hemicraniectomy after malignant middle cerebral artery infarction: Rationale and controversies

Omar M. Arnaout; Salah G. Aoun; H. Hunt Batjer; Bernard R. Bendok

doi:10.3171/2011.3.FOCUS1160

Decompressive hemicraniectomy after malignant middle cerebral artery infarction: Rationale and controversies

Omar M. Arnaout, Salah G. Aoun, H. Hunt Batjer, Bernard R. Bendok

Research output: Contribution to journal › Article › peer-review

27 Scopus citations

Abstract

Malignant middle cerebral artery stroke carries a very poor prognosis. Significant retrospective data support the hypothesis that decompressive hemicraniectomy decreases mortality rates due to this disease entity. Recently, 3 randomized controlled studies have been published and shed light on these issues and enhance the quality of evidence revolving around this procedure. In this review, the rationale, risks, benefits, and unanswered questions related to hemicraniectomy for acute ischemic stroke are reviewed with an emphasis on how 3 randomized trials have influenced knowledge on this life-saving yet controversial procedure. Further randomized studies are needed to clarify lingering questions regarding age indications and impact on quality of life.

Original language	English (US)
Article number	E18
Journal	Neurosurgical focus
Volume	30
Issue number	6
DOIs	https://doi.org/10.3171/2011.3.FOCUS1160
State	Published - Jun 2011

Keywords

Craniectomy
Hemicraniectomy
Malignant stroke
Patient outcome
Quality of life
Randomized controlled trial

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.3171/2011.3.FOCUS1160

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abstract = "Malignant middle cerebral artery stroke carries a very poor prognosis. Significant retrospective data support the hypothesis that decompressive hemicraniectomy decreases mortality rates due to this disease entity. Recently, 3 randomized controlled studies have been published and shed light on these issues and enhance the quality of evidence revolving around this procedure. In this review, the rationale, risks, benefits, and unanswered questions related to hemicraniectomy for acute ischemic stroke are reviewed with an emphasis on how 3 randomized trials have influenced knowledge on this life-saving yet controversial procedure. Further randomized studies are needed to clarify lingering questions regarding age indications and impact on quality of life.",

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AU - Bendok, Bernard R.

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AB - Malignant middle cerebral artery stroke carries a very poor prognosis. Significant retrospective data support the hypothesis that decompressive hemicraniectomy decreases mortality rates due to this disease entity. Recently, 3 randomized controlled studies have been published and shed light on these issues and enhance the quality of evidence revolving around this procedure. In this review, the rationale, risks, benefits, and unanswered questions related to hemicraniectomy for acute ischemic stroke are reviewed with an emphasis on how 3 randomized trials have influenced knowledge on this life-saving yet controversial procedure. Further randomized studies are needed to clarify lingering questions regarding age indications and impact on quality of life.

KW - Craniectomy

KW - Hemicraniectomy

KW - Malignant stroke

KW - Patient outcome

KW - Quality of life

KW - Randomized controlled trial

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Decompressive hemicraniectomy after malignant middle cerebral artery infarction: Rationale and controversies

Abstract

Keywords

ASJC Scopus subject areas

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