Comparison of the decompressive surgery and medical therapy alone results in malignant middle cerebral artery infarction

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Purpose:The purpose of this study is to compare the morbidity and mortality properties of patients withdecompressive surgery or medical treatment in malignant middle cerebral artery infarcts. Materials and Methods:28 patients with malignant middle cerebral artery infarct treated with decompressive surgery or medical therapy in Pamukkale University Neurology clinic enrolled in the study. Patients treated with decompressive surgery were compared with patients treated with medical theraphy alone on functional status, prognosis and survival rates. Results:In one month follow up, 4 patient survived and 10 patients were exitus in decompressive surgery group and 7 patients survived and 7 patients were exitus in medical therapy group. 6 patients survived and 7 patients were exitus of 13 patients who were under the age of 65 and 5 patients survived and 10 patients were exitus of 15 patients who were over the age of 65. 9 of the 15 patients with more than 1 risk factor were in decompressive surgery group and 2 patients survived in one month follow up. 7 of the 13 patients with 1 or less risk factor survived and 5 of this 7 patients were in medical therapy group (p: 0,011). Conclusion:Decompressive craniectomy should be considered in patients under the age of 65 with 1 or less risk factor when surgery performed within 48 hours for less mortality.

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Stroke , Malign Middle Cerebral Artery İnfarct , Decompressive Craniectomy , Medical Therapy

Pamukkale Medical Journal

142

Pamukkale Medical Journal