title: Hydrocephalus following decompressive craniectomy for malignant middle cerebral artery infarction.
abstract: OBJECTIVE
  The aim of this study was to evaluate the incidence of hydrocephalus and understand the influence of hydrocephalus on the functional outcome of patients undergoing decompressive craniectomy for malignant middle cerebral artery (MCA) infarction.
  
  
  METHODS
  We retrospectively analyzed data of consecutive patients who underwent decompressive craniectomy for malignant MCA infarction. Clinical and imaging data were reviewed to confirm the incidence of hydrocephalus and evaluate the impact of hydrocephalus on functional outcome. The functional outcomes of patients were estimated with the Glasgow outcome score at 1year after stroke onset.
  
  
  RESULTS
  Seventeen patients who received decompressive craniectomy for malignant MCA infarction from January 2003 to December 2006 were enrolled. Persistent hydrocephalus developed in 5 patients. The functional outcomes in these patients were uniformly poor regardless of cerebrospinal fluid diversion surgery. Our data revealed that functional outcome was related to patient age and the duration from infarction to craniectomy.
  
  
  CONCLUSIONS
  Persistent hydrocephalus is common in patients who receive decompressive craniectomy for malignant MCA infarction. However, the shunt procedure does not significantly improve the patient's clinical condition. The timing of operation in relation to the functional outcome may be critical.
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital, Chia-Yi Center, Chiayi, Taiwan.
authors.forename: Ming-Hsueh
authors.initials: MH
authors.lastname: Lee
authors.forename: Jen-Tsung
authors.initials: JT
authors.lastname: Yang
authors.forename: Hsu-Huei
authors.initials: HH
authors.lastname: Weng
authors.forename: Yu-Kai
authors.initials: YK
authors.lastname: Cheng
authors.forename: Martin Hsiu-Chu
authors.initials: MH
authors.lastname: Lin
authors.forename: Chen-Hsing
authors.initials: CH
authors.lastname: Su
authors.forename: Chia-Mao
authors.initials: CM
authors.lastname: Chang
authors.forename: Ting-Chung
authors.initials: TC
authors.lastname: Wang
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000209:etiology; D003399:Craniotomy / Q000379:methods; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000601:surgery; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt