RESULTS OF DECOMPRESS CRANIOECTOMY FOR PATIENT WITH CEREBRAL INFARCTION DUE TO CEREBRAL ARTERY OCCLUTION AT HANOI MEDICAL UNIVERSITY HOSPITAL
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Abstract
Background: Malignant cerebral infarction is a severe condition with high mortality rates. Decompressive craniectomy may improve patient outcomes. Objective: To evaluate the resuscitation outcomes of patients with severe cerebral infarction due to MCA and posterior fossa occlusion who underwent decompressive craniectomy. Methods: A non-controlled interventional study was conducted on 58 patients (53 with MCA infarction, 5 with posterior fossa infarction) at Hanoi Medical University Hospital from 2016 to 2021. Results: The overall 90-day mortality rate was 22.6%, with no deaths in the posterior fossa infarction group. The proportion of patients with a favorable clinical outcome (mRS 0-3) after 90 days was 39.6%, reaching 80% in the posterior fossa infarction group. Favorable prognostic factors included age ≤ 60, NIHSS score ≤ 18, ASPECTs score 4-6, isolated MCA occlusion, and timely reperfusion therapy during the “golden hour.” Conclusion: Decompressive craniectomy improves prognosis in malignant cerebral infarction, particularly in posterior fossa infarction. Early intervention and reperfusion therapy play a crucial role in clinical outcomes.
Article Details
Keywords
Malignant cerebral infarction, middle cerebral artery occlusion, posterior fossa infarction, decompressive craniectomy
References

2. Chen B, Sun Y, Wei Z, et al. Long-term prognosis of patients with stroke associated with middle cerebral artery occlusion. Single- centre registration study. Archives of medical science : AMS. 2022;18(5):1199-1207.

3. Bao YH, Liang YM, Gao GY, et al. Bilateral decompressive craniectomy for patients with malignant diffuse brain swelling after severe traumatic brain injury: a 37-case study. Journal of neurotrauma. 2010;27(2):341-347.

4. Frank JI, Schumm LP, Wroblewski K, et al. Hemicraniectomy and durotomy upon deterioration from infarction-related swelling trial: randomized pilot clinical trial. Stroke. 2014;45(3):781-787.

5. Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. 2018;49(3):e46-e99.
