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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(07): 424-428
DOI: 10.1590/0004-282X20170053
ARTICLES

Decompressive craniotomy for the treatment of malignant infarction of the middle cerebral artery: mortality and outcome

Craniotomia descompressiva para tratamento do infarto maligno da artéria cerebral media: mortalidade e desfecho
Gianise Toboliski Bongiorni
1   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas - Ciência Cirúrgica, Porto Alegre RS, Brasil;
,
Marjeane Cristina Jaques Hockmuller
1   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas - Ciência Cirúrgica, Porto Alegre RS, Brasil;
,
Cristini Klein
2   Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre RS, Brasil;
,
Ápio Cláudio Martins Antunes
3   Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Serviço de Neurocirurgia, Porto Alegre RS, Brasil.
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ABSTRACT

Objective

To assess, by Rankin scale, the functional disability of patients who had a malignant middle cerebral artery (MCA) ischemic stroke, who underwent decompressive craniotomy (DC) within the first 30 days.

Methods

A cross-sectional study in a University hospital. Between June 2007 and December 2014, we retrospectively analyzed the records of all patients submitted to DC due to a malignant MCA infarction. The mortality rate was defined during the hospitalization period. The modified outcome Rankin score (mRS) was measured 30 days after the procedure, for stratification of the quality of life.

Results

The DC mortality rate was 30% (95% CI 14.5 to 51.9) for the 20 patients reported. The mRS 30 days postoperatively was ≥ 4 [3.3 to 6] for all patients thereafter.

Conclusion

DC is to be considered a real alternative for the treatment of patients with a malignant ischemic MCA infarction.

RESUMO

Objetivo

Avaliar a capacidade funcional de pacientes com acidente vascular cerebral isquêmico no território da artéria cerebral média (ACM) submetidos à craniotomia descompressiva (CD) no período de 30 dias pela escala de Rankin.

Métodos

Estudo transversal em um hospital universitário. Entre junho de 2007 e dezembro de 2014, analisados retrospectivamente os registros de todos os pacientes submetidos a CD devido a enfarte maligno na ACM. A taxa de mortalidade foi definida durante o período de internação. O resultado da estratificação da qualidade de vida foi através da escala Rankin modificado (mRS) mensurado em 30 dias após o procedimento.

Resultados

A taxa de mortalidade CD foi de 30% (IC 95% 14,5-51,9) para os 20 pacientes relatados. A mRS 30 dias de pós-operatório foi => 4 [3,3-6] para todos os pacientes.

Conclusão

CD deve ser considerada uma alternativa real para o tratamento de pacientes com enfarte isquêmico no território da ACM.

craniotomy - cerebral infarction - intracranial hypertension
craniotomia - infarto cerebral - hipertensão intracraniana


Publication History

Received: 30 November 2016

Accepted: 14 February 2017

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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