Friday, April 13, 2012

Postoperative midline shift as secondary screening for the long-term outcomes of surgical decompress

Publication year: 2012
Source:Journal of Clinical Neuroscience, Volume 19, Issue 5
Po-Hsun Tu, Zhuo-Hao Liu, Chi-Cheng Chuang, Tao-Chieh Yang, Chieh-Tsai Wu, Shih-Tseng Lee
Decompressive hemicraniectomy (DC) can save the lives of patients with malignant middle cerebral artery (MCA) infarction. We proposed that postoperative midline shift is important for the long-term outcome of patients with MCA infarction. We conducted a retrospective study of DC in 38 patients with malignant MCA infarction. The long-term outcome was assessed one year after surgery using the modified Rankin Scale (mRS) score. Patients who had midline shift less than the optimal diagnostic cut-off point on the fourth postoperative day were classified as having a successful decompression and the remaining patients were classified in the failed decompression group. The successful decompression group mRS score was 4.20±0.89 one year after surgery and the failed decompression group mRS score was 5.11±0.76 (p <0.0001). Successful decompression, resulting in postoperative midline shift of less than 5mm, was a key factor for beneficial, long-term functional outcomes in patients with malignant MCA infarction.






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