Decompression Craniotomy in the Complex Intensive Therapy of Malignant Forms of Massive Ischemic Stroke

• Published in: Neuroscience and behavioral physiology Vol. 44; no. 3; pp. 323 - 330
• Main Authors: Krylov, V. V., Nikitin, A. S., Burov, S. A., Petrikov, S. S., Asratyan, S. A., Averin, A. Yu, Kol’yak, E. V.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.03.2014; Springer Nature B.V
• Subjects: Behavioral Sciences; Biomedical and Life Sciences; Biomedicine; Brain damage; Coma; Consciousness; Edema; Illnesses; Ischemia; Neurobiology; Neurosciences; Risk factors; Stroke; risk factors; decompression craniotomy; brain dislocation; massive ischemic stroke
• ISSN: 0097-0549; 1573-899X
• DOI: 10.1007/s11055-014-9913-6

The course of massive ischemic stroke (MIS) was studied in 105 patients. The results of investigations and intensive treatment identified a group of patients in which the course of MIS was benign, with no development of dislocation syndrome, and a group with a malignant course, with development of hemisphere cerebral edema and further transtentorial impact. Risk factors for the development of the malignant form of MIS and lethal outcomes were identified: lateral dislocation of greater than 7 mm, volume of ischemia greater than 70% of the frontal and parietal lobes and more than 80% of the temporal lobe, and impairment to the level of consciousness to moderate coma and worse. These were used to form a group of patients who underwent decompression craniotomy on the side of the lesioned hemisphere. This decreased lethality more than twofold compared with patients treated conservatively.