[Surgical decompression in space-occupying cerebral infarct; notification of a randomized trial].
Patients with a hemispheric infarct and massive space-occupying brain oedema have a poor prognosis. Despite intensive conservative treatment, the case fatality rate may be as high as 80%, and most survivors are left severely disabled. Non-randomised studies suggest that decompressive surgery substantially reduces mortality and improves the functional outcome of survivors. The 'Hemicraniectomy after middle cerebral artery infarction with life-threatening edema trial' (HAMLET) is a newly-conceived randomised multi-centre clinical trial that compares the efficacy of decompressive surgery to improve functional outcome with that of conservative treatment in patients with space-occupying supratentorial infarction.
Hofmeijer
J
J
Universitair Medisch Centrum Utrecht, Postbus 85.500, 3508 GA Utrecht. j.hofmeijer@neuro.azu.nl
van der Worp
H B
HB
Amelink
G J
GJ
Algra
A
A
van Gijn
J
J
Kappelle
L J
LJ
D001921:Brain / Q000601:surgery; D002544:Cerebral Infarction / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D019299:Decompression, Surgical; D006801:Humans; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D016896:Treatment Outcome