EARLY RESULTS OF DECOMPRESSIVE HEMICRANIECTOMY OF LARGE MIDDLE CEREBRAL ARTERY INFARCTION AT MILITARY HOSPITAL 103

Anh Đức Trần 1, Thành Bắc Nguyễn 1, Mạnh Linh Hoàng 1, Quang Hùng Ngô 2,
1 Vietnam Military Medical Academy
2 Xanh Pôn hospital

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Abstract

Objectives: Evaluate the results of decompressive craniotomy to treat large-scale cerebral infarction due to middle cerebral artery occlusion at Military Hospital 103. Subjects and methods: Clinical tissue research on 32 patients with large cerebral infarction due to middle cerebral artery occlusion at Military Hospital 103 from January 2017 to September 2022. Evaluation of early results after surgery. Results: Survival rate at hospital discharge reached 96.9%. Early results showed that 59.4% improved consciousness compared to before surgery. Computed tomography scans showed a decrease in the level of midline displacement; the number of patients with midline displacement of grades III and IV decreased from 18.7% to 15.6%. Conclusion: Open decompression surgery to treat large-scale cerebral infarction due to middle cerebral artery occlusion shows good results in terms of consciousness, reducing the level of midline pressure.

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References

1. B. Daou, A. P. Kent, M. Montano, et al. (2016). Decompressive hemicraniectomy: predictors of functional outcome in patients with ischemic stroke. J Neurosurg, 124(6): 1773-9.
2. S. Das, P. Mitchell, N. Ross, et al. (2019). Decompressive Hemicraniectomy in the Treatment of Malignant Middle Cerebral Artery Infarction: A Meta-Analysis. World Neurosurg, 123: 8-16.
3. William J. Powers, Alejandro A. Rabinstein, Teri Ackerson, et al. (2018). 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/ American Stroke Association49(3): e46-e99.
4. B. Kamal Alam, A. S. Bukhari, S. Assad, et al. (2017). Functional Outcome After Decompressive Craniectomy in Patients with Dominant or Non-Dominant Malignant Middle Cerebral Infarcts. Cureus, 9(1): e997.
5. D. Staykov, R. Gupta (2011). Hemicraniectomy in malignant middle cerebral artery infarction. Stroke, 42(2): 513-6.
6. Katayoun Vahedi, Eric Vicaut, Joaquim Mateo, et al. (2007). Sequential-Design, Multicenter, Randomized, Controlled Trial of Early Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarction (DECIMAL Trial)38(9): 2506-2517.
7. J. Hofmeijer, L. J. Kappelle, A. Algra, et al. (2009). Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial. Lancet Neurol, 8(4): 326-333.
8. Katayoun Vahedi, Jeannette Hofmeijer, Eric Juettler, et al. (2007). Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. The Lancet Neurology, 6(3): 215-222.
9. E. Jüttler, S. Schwab, P. Schmiedek, et al. (2007). Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery (DESTINY): a randomized, controlled trial. Stroke, 38(9): 2518-2525.
10. Dae-Hyun Kim, Sang-Bae Ko, Jae-Kwan Cha, et al. (2015). Updated Korean Clinical Practice Guidelines on Decompressive Surgery for Malignant Middle Cerebral Artery Territory Infarction. Journal of stroke, 17(3): 369-376.