Postoperative midline shift as secondary screening for the long-term outcomes of surgical decompression of malignant middle cerebral artery infarcts

作者：Tu Po Hsun; Liu Zhuo Hao; Chuang Chi Cheng; Yang Tao Chieh; Wu Chieh Tsai; Lee Shih Tseng^*

来源：Journal of Clinical Neuroscience, 2012, 19(5): 661-664.

DOI：10.1016/j.jocn.2011.07.045

• Decompression surgery
• Hemicraniectomy
• Infarct
• Middle cerebral artery
• Mortality
• Outcome

Decompressive hemicraniectomy (DC) can save the lives of patients with malignant middle cerebral artery (MCA) infarction. We proposed that postoperative midline shift is important for the long-term outcome of patients with MCA infarction. We conducted a retrospective study of DC in 38 patients with malignant MCA infarction. The long-term outcome was assessed one year after surgery using the modified Rankin Scale (mRS) score. Patients who had midline shift less than the optimal diagnostic cut-off point on the fourth postoperative day were classified as having a successful decompression and the remaining patients were classified in the failed decompression group. The successful decompression group mRS score was 4.20 +/- 0.89 one year after surgery and the failed decompression group mRS score was 5.11 +/- 0.76 (p %26lt; 0.0001). Successful decompression, resulting in postoperative midline shift of less than 5 mm, was a key factor for beneficial, long-term functional outcomes in patients with malignant MCA infarction.

• 出版日期2012-5
• 单位长春大学