title: Effect of decompressive hemicraniectomy on mortality of malignant middle cerebral artery infarction.
abstract: BACKGROUND
  Increasing intracranial pressure (ICP) is one of the leading causes of mortality in patients with malignant infarction of the middle cerebral artery (MCA). We prospectively evaluated patients with MCA infarction for one month survival after decompressive hemicraniectomy.
  
  
  METHODS
  This study was conducted at Alzahra University Hospital, Isfahan (Iran). Twenty patients with infarction in total MCA distribution area, resulting in midline shift of brain tissue for greater than 5mm, underwent decompressive hemicraniectomy. Mortality rate was estimated one month after surgery.
  
  
  RESULTS
  Patients were 8 (40%) males and 12 (60%) females with a mean age of 49.9 ± 3.8 (25 to 70) years. Left and right MCA were involved in 7 (35%) and 13 (65%) patients, respectively. Four (20%) patients died within one month after surgery (3 females and one male, mean age of 59.0 ± 4.5 vs. 47.6 ± 3.4 in survived patients, p < 0.001). The mean of baseline Glasscow Coma Scale (GCS) score estimated 8.60 ± 1.55 in survived patients and 6.75 ± 0.95 in patients who died (p < 0.05).
  
  
  CONCLUSIONS
  The survival rate of malignant MCA infarction treated with decompressive hemicraniectomy was the same as previous reports. MCA infarction mortality increased with age and lower admission GCS score.
authors.affiliation: Associate Professor of Neurosurgery, Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Aminmansour
authors.forename: Majeed
authors.initials: M
authors.lastname: Rezvany
authors.forename: Davood
authors.initials: D
authors.lastname: Sharifi
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Shemshaki