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

Po Hsun Tu, Zhuo Hao Liu, Chi Cheng Chuang, Tao Chieh Yang, Chieh Tsai Wu, Shih Tseng Lee*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations

Abstract

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 < 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.

Original languageEnglish
Pages (from-to)661-664
Number of pages4
JournalJournal of Clinical Neuroscience
Volume19
Issue number5
DOIs
StatePublished - 05 2012
Externally publishedYes

Keywords

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

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