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SHR Neuro Cancer Cardio Lipid Metab 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 [OPEN ACCESS]
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Leading authors Med Uni Graz
Berger Natalie
Kneihsl Markus
Co-authors 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
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