title: Decompressive hemicraniectomy with duraplasty: a treatment for large-volume ischemic stroke.
abstract: Increased intracranial pressure (ICP) is a cause of death and disability in neurological patients. Patients experiencing malignant stroke of the middle cerebral artery (MCA) have a high mortality related to cerebral edema, increased ICP, and subsequent cerebral herniation. Decompressive hemicraniectomy with duraplasty is a surgical option for those experiencing large volume MCA stroke. When decompressive hemicraniectomy with duraplasty is performed, functional outcomes improve if the MCA stroke candidate is younger, the onset of increased ICP occurred less than 24 hours before surgery, and surgery is performed before clinical signs of herniation syndrome occur. The level of care required for these patients makes nursing care challenging.
authors.affiliation: Nursing at Purdue University Calumet in Hammond, IN, USA. tazbir@calumet.purdue.edu
authors.forename: Janice
authors.initials: J
authors.lastname: Tazbir
authors.forename: Maureen T
authors.initials: MT
authors.lastname: Marthaler
authors.forename: Cheryl
authors.initials: C
authors.lastname: Moredich
authors.forename: Patricia
authors.initials: P
authors.lastname: Keresztes
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D001672:Biocompatible Materials / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods; D002543:Cerebral Hemorrhage / Q000150:complications*; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D004388:Dura Mater / Q000601:surgery*; D004677:Encephalocele / Q000209:etiology; D023261:Glasgow Outcome Scale; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications*; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D024802:Nurse's Role; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods / Q000451:nursing; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials