Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Berger, N; Brunner, A; Wünsch, G; Nistl, O; Pinter, D; Fandler-Höfler, S; Haidegger, M; Pichler, A; Hatab, I; Mokry, M; Wolfsberger, S; Enzinger, C; Gattringer, T; Kneihsl, M.
Long-term outcome after decompressive hemicraniectomy for malignant middle cerebral artery infarction.
J Neurol. 2023; 270(7):3475-3482
Doi: 10.1007/s00415-023-11679-1
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- Führende Autor*innen der Med Uni Graz
- Berger Natalie
- Kneihsl Markus
- Co-Autor*innen der Med Uni Graz
- Brunner Anna
- Enzinger Christian
- Fandler-Höfler Simon
- Gattringer Thomas
- Haidegger Melanie
- Hatab Isra
- Mokry Michael
- Nistl Oliver
- Pichler Alexander
- Pinter Daniela Theresia
- Wolfsberger Stefan
- Wünsch Gerit
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- Abstract:
- BACKGROUND: Although decompressive hemicraniectomy (DHC) is a lifesaving treatment strategy for patients with malignant middle cerebral artery infarction (mMCAi), only one in four patients achieves low to moderate post-stroke disability according to previous studies. However, the short follow-up periods in prior studies could have overestimated the poor clinical prognosis. This study therefore examined the long-term outcome after DHC for mMCAi. METHODS: We retrospectively included all patients who had undergone DHC after mMCAi at the University Hospital Graz between 2006 and 2019. Demographics, clinical data and complications were collected from electronic clinical patient records. To investigate long-term prognosis, all patients were followed up to 14 years after stroke including quality of life (QOL) assessment. Post-stroke disability was rated according to the modified Rankin Scale (mRS). RESULTS: Of 47 patients that had undergone DHC for mMCAi, follow-up data were available in 40 patients (mean age: 48 years; 40% female). Six months after the mMCAi, 14 patients had died (35%) and nine (23%) had a low to moderate post-stroke disability (mRS 0-3). Of 26 stroke survivors, half (50%) showed further mRS improvement (≥ 1 point) during the long-term follow-up period (mean follow-up time: 8 years). At last follow-up, 17 patients had achieved an mRS score of ≤ 3 (65% versus 35% after 6 months; p = 0.008) and 55% had no signs of depression and anxiety, and 50% no signs of pain or discomfort in QOL assessment. CONCLUSION: This study shows substantial long-term improvement of functional disability and reasonable QOL in mMCAi patients after DHC.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Female - administration & dosage
- Middle Aged - administration & dosage
- Male - administration & dosage
- Infarction, Middle Cerebral Artery - surgery, complications
- Quality of Life - administration & dosage
- Treatment Outcome - administration & dosage
- Decompressive Craniectomy - administration & dosage
- Retrospective Studies - administration & dosage
- Stroke - complications
- Find related publications in this database (Keywords)
- Ischemic stroke
- Decompressive hemicraniectomy
- Long-term outcome
- Quality of life
- Rehabilitation