Decompression Craniotomy in the Complex Intensive Therapy of Malignant Forms of Massive Ischemic Stroke

Krylov, V.; Nikitin, A.; Burov, S.; Petrikov, S.; Asratyan, S.; Averin, A.; Kol'yak, E.
March 2014
Neuroscience & Behavioral Physiology;Mar2014, Vol. 44 Issue 3, p323
Academic Journal
The course of massive ischemic stroke (MIS) was studied in 105 patients. The results of investigations and intensive treatment identified a group of patients in which the course of MIS was benign, with no development of dislocation syndrome, and a group with a malignant course, with development of hemisphere cerebral edema and further transtentorial impact. Risk factors for the development of the malignant form of MIS and lethal outcomes were identified: lateral dislocation of greater than 7 mm, volume of ischemia greater than 70% of the frontal and parietal lobes and more than 80% of the temporal lobe, and impairment to the level of consciousness to moderate coma and worse. These were used to form a group of patients who underwent decompression craniotomy on the side of the lesioned hemisphere. This decreased lethality more than twofold compared with patients treated conservatively.


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