Journal of Korean Society of Geriatric Neurosurgery 2016;12(2):227-231.
Published online September 30, 2016.
Decompressive Craniectomy for Malignant Middle Cerebral Artery Infarction in Elderly Patients: Single Center Result
Ki-Chang Yi , Sung-Tae Kim , Yeong-Seo Lee , Ho-Su Kim , Keun-Su Lee , Won-Hee Lee , Young-Kyun Jeong , Moo-Seong Kim , Yong-Tae Jung
Department of Neurosurgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
노인 환자의 중뇌 동맥경색에서 감압적 개두술의 효용성
인제대학교 의과대학 부산백병원 신경외과학교실
We report our results on the study of of elderly patients treated with decompressive craniectomy for malignant middle cerebral artery infarction and compare them with the results from young patents.
This is a retrospective review of patients who developed malignant middle cerebral artery infarction and underwent decompressive craniectomy. From January 2008 to March 2011, 62 patients underwent operations for decompressive craniectomy. Among them, 15 patients were excluded from our analysis. Patients over 60 years old were defined as “elderly.” We analyzed mortality and clinical outcomes using the modified Rankin Scale score in the two groups. We analyzed surgical timing and clinical factors in elderly patients.
The mean age of all patients was 61.23 years. The mean age of the elderly patients was 68.1 years. The rates of mortality and favorable outcomes among elderly patients were 29.6% and 48.1%, respectively, which were not statistically different from the rates in young patients. The National Institutes of Health Stroke Scale scores at admission and operation were statistically related to favorable outcome (p=0.028 and 0.020). Dominant hemisphere involvement and inclusion of the anterior cerebral artery or posterior cerebral artery were related with borderline unfavorable outcomes (p=0.103 and 0.077).
Decompressive craniectomy for malignant middle cerebral artery infarction in eldery patients is effective. However, it it carries a risk of serious morbidity in many cases.
Key Words: Decompressive craniectomy, Cerebral infarction

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