title: Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Infarct.
abstract: OBJECTIVE
  Decompressive hemicraniectomy for a malignant middle cerebral artery infarct can be a life-saving surgical treatment. We aimed to investigate the surgical treatment results in cases that underwent decompressive hemicraniectomy for a malignant middle cerebral artery infarct in this study.
  
  
  METHODS
  The clinical condition, radiological findings and surgical treatment results of 42 cases that underwent decompressive hemicraniectomy for a malignant middle cerebral artery infarct were retrospectively evaluated in this study.
  
  
  RESULTS
  There were 19 males and 23 females. The age range was 27 to 78 years with a mean age of 57.6 years. The infarct area was the non-dominant hemisphere in 20 cases and the dominant hemisphere in 22 cases. Preoperative Glasgow coma scale (GCS) scores were 5 to 12. The 42 cases with a malignant middle cerebral artery infarct were divided into 2 groups according to the Glasgow outcome scale (GOS) as the unfavorable outcome group (Group 1) with a score of 1 to 3 and the favorable outcome group with a score of 4 to 5 (Group 2). There were 27 cases in Group 1 and 15 in Group 2. There was a statistically significant association between a good result and age, Glasgow coma scale at the time of surgery, duration until surgery, and non-dominant hemisphere involvement. All cases with a Glasgow coma scale score of 7 or below had a poor outcome.
  
  
  CONCLUSIONS
  Decompressive hemicraniectomy in malignant middle cerebral artery infarct can be a life-saving procedure but is not useful in cases with a Glasgow coma scale score of 7 and below.
authors.affiliation: Ankara Training and Research Hospital, Neurosurgery Clinic, Ankara, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Gulensoy
authors.forename: Mete
authors.initials: M
authors.lastname: Karatay
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Erdem
authors.forename: Haydar
authors.initials: H
authors.lastname: Celik
authors.forename: Tuncer
authors.initials: T
authors.lastname: Tascioglu
authors.forename: Idris
authors.initials: I
authors.lastname: Sertbas
authors.forename: Tansu
authors.initials: T
authors.lastname: Gursoy
authors.forename: Halil
authors.initials: H
authors.lastname: Kul
authors.forename: Cevdet
authors.initials: C
authors.lastname: Gokcek
authors.forename: Ugur
authors.initials: U
authors.lastname: Yasitli
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Bayar
mesh_terms: D000328:Adult; D000368:Aged; D056424:Decompressive Craniectomy; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome