Factors affecting the outcome of decompressive craniectomy for large hemispheric infarctions: a prospective cohort study

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dc.authoridSimsek, Osman/0000-0002-8716-5187
dc.authoridHicdonmez, Tufan/0000-0003-4847-8727
dc.authoridHamamcioglu, Mustafa Kemal/0000-0003-1960-8182
dc.authorwosidKILINÇER, Cumhur/C-7969-2014
dc.authorwosidSimsek, Osman/D-4906-2012
dc.authorwosidHicdonmez, Tufan/AGI-0165-2022
dc.authorwosidHamamcioglu, Mustafa Kemal/A-3520-2019
dc.contributor.authorKilincer, C
dc.contributor.authorAsil, T
dc.contributor.authorUtku, U
dc.contributor.authorHamamcioglu, MK
dc.contributor.authorTurgut, N
dc.contributor.authorHicdonmez, T
dc.contributor.authorSimsek, O
dc.date.accessioned2024-06-12T10:55:09Z
dc.date.available2024-06-12T10:55:09Z
dc.date.issued2005
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackground. Although surgical decompression of large hemispheric infarction is often a life-saving procedure, many patients remain functionally dependent. The aims of this study were to identify specific factors that can be used to predict functional outcome, thus establish predictive criteria to reduce poor surgical results. Method. In this non-randomized prospective study, we performed decompressive craniectomy in 32 patients (age range, 27 to 77 years) with large hemispheric infarctions. Based on their modified Rankin Score (RS), which was calculated 6 months postoperatively, patients were divided into two functional groups: good (RS 0-3, n = 7) and poor (RS 4-6, n = 25). The characteristics of the two groups were compared using statistical analysis. Findings. One-month mortality was 31%. However, most of the surviving patients were severely disabled (RS 4 or 5), and 6-month total mortality reached 50%. Increased age (>= 60 years) (P = 0.010), preoperative midline shift greater than 10 mm (P = 0.008), low preoperative Glasgow Coma Score (GCS <= 7) (P = 0.002), presence of preoperative anisocoria (P = 0.032), early (within the first three days of the stroke) clinical deterioration (P = 0.032), and an internal carotid artery infarct (P = 0.069) were the positive predictors of a poor outcome. Interpretation. We view decompressive craniectomy for space-occupying large hemispheric infarction as a life-sparing procedure that sometimes yields good functional outcomes. A dominant hemispheric infarction should not be an exclusion criterion when deciding to perform this operation. Early operation and careful patient selection based on the above-mentioned factors may improve the functional outcome of surgical management for large hemispheric infarction.en_US
dc.identifier.doi10.1007/s00701-005-0493-7
dc.identifier.endpage594en_US
dc.identifier.issn0001-6268
dc.identifier.issn0942-0940
dc.identifier.issue6en_US
dc.identifier.pmid15739038en_US
dc.identifier.scopus2-s2.0-21044432057en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage587en_US
dc.identifier.urihttps://doi.org/10.1007/s00701-005-0493-7
dc.identifier.urihttps://hdl.handle.net/20.500.14551/19300
dc.identifier.volume147en_US
dc.identifier.wosWOS:000229614300001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringer Wienen_US
dc.relation.ispartofActa Neurochirurgicaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBrain Oedemaen_US
dc.subjectCerebral Infarctionen_US
dc.subjectCraniotomyen_US
dc.subjectMiddle Cerebral Artery Infarctionen_US
dc.subjectSurgical Decompressionen_US
dc.subjectTreatment Outcomeen_US
dc.subjectCerebral-Artery Territoryen_US
dc.subjectStrokeen_US
dc.subjectHemicraniectomyen_US
dc.subjectSurgeryen_US
dc.titleFactors affecting the outcome of decompressive craniectomy for large hemispheric infarctions: a prospective cohort studyen_US
dc.typeArticleen_US

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