Hemicraniectomy for malignant middle cerebral artery infarction.
OBJECTIVE
Space-occupying, malignant hemispheric infarction is one of the most devastating forms of ischemic stroke. Several case series had suggested decompressive hemicraniectomy as a life-saving therapy, but, until recently, there was no proof for this procedure from randomized controlled trials.


RESULTS
In 2007, results from a pooled analysis of three European trials as well as data from two of these trials were published and yield compelling evidence for the benefit of hemicraniectomy.


CONCLUSIONS
Data from the published trials leave no doubt about the benefit especially the life-saving character of hemicraniectomy for malignant hemispheric infarction. However, some open questions (i.e. timing of surgery, age limit for hemicraniectomy) remain to be answered in the future.
Köhrmann
Martin
M
Department of Neurology, University of Erlangen, Erlangen, Germany. martin.koehrmann@uk-erlangen.de
Schwab
Stefan
S
D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007362:Intensive Care Units; D011859:Radiography; D016896:Treatment Outcome