Outcome of decompressive craniotomy in malignant middle cerebral artery infarction: a retrospective study | ||
| Journal of Medical and Life Science | ||
| Article 1, Volume 7, Issue 4, December 2025, Pages 604-611 PDF (1016.14 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/jmals.2025.415717.1067 | ||
| Authors | ||
| Sandip Pal* 1; Samhita Pal2 | ||
| 1Department of Neurosurgery Medical Cllege Hospital Kolkata, West Bengal, India | ||
| 2Department of Statistics North Carolina State University Raleigh,NC, USA | ||
| Abstract | ||
| Malignant middle cerebral artery (MCA) infarction, caused by complete Middle cerebral artery occlusion, produces extensive cerebral edema, which causes rapid neurological deterioration. Though the incidence of this entity is 1-10% of all MCA territory infarcts, it has a high mortality of up to 80%. Decompressive craniotomy, as a measure to combat the edema, is an established procedure. In this ten-year retrospective study, we performed decompressive craniotomy, as a lifesaving procedure, in 86 selected patients, under 65 years of age, diagnosed with malignant MCA infarction, and compared our results with 68 patients, of the same age group, treated solely on medical therapy. 92 patients were excluded from this study for age>65 years/ GCS<5/ dilated and non-reacting pupil/had taken rTPA, 12 hours before the time of surgery plan. Our study result was also compared to other similar studies. We found the mortality is 25.58% in the surgery group, as compared to 48.53% of the patients treated medically. We concluded that craniotomy done within 48hours of admission definitely improves the mortality rate. | ||
| Keywords | ||
| Stroke; Malignant MCA infarction; Decompressive craniotomy | ||
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