Decompressive craniectomy for malignant middle cerebral artery infarction at an emergency hospital in Peru

Objective: To describe clinical, surgical and post-operative characteristics in patients with the diagnosis of malignant infarction of the middle cerebral artery who underwent decompressive craniectomy. Methods: Descriptive, retrospective case series study, performed between March 2017 and March 202...

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Detalles Bibliográficos
Autores: Celi, Fernando, Saal-Zapata, Giancarlo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:Perú
Institución:Universidad Peruana Cayetano Heredia
Repositorio:Revistas - Universidad Peruana Cayetano Heredia
Idioma:español
OAI Identifier:oai:revistas.upch.edu.pe:article/4245
Acceso en línea:https://revistas.upch.edu.pe/index.php/RMH/article/view/4245
Access Level:acceso abierto
Palabra clave:Arteria cerebral media
craniectomía descompresiva
isquemia cerebral
Middle cerebral artery
decompressive craniectomy
brain ischemia
Descripción
Sumario:Objective: To describe clinical, surgical and post-operative characteristics in patients with the diagnosis of malignant infarction of the middle cerebral artery who underwent decompressive craniectomy. Methods: Descriptive, retrospective case series study, performed between March 2017 and March 2020. Data from consecutive patients with the diagnosis of malignant middle cerebral artery infarction were collected. Results: Ten cases were reviewed. Eighty percent of the patients were men, the mean age was 64 years and 60% of the patients were older than 60 years. At admission, the mean Glasgow was 11 points and the mean mRS was 4. The mean time from diagnosis to surgery was 89.7 hours. The anterior cerebral artery was comprised in two cases. Hemorrhagic transformation occurred in three cases. The mean anterior-posterior diameter of the skull flap was 116 mm. The mean ICU and hospital length of stay was 14.1 and 27.5 days, respectively. Three patients died. Conclusions: Decompressive craniectomy is a life-saving procedure in an emergency hospital-setting with an acceptable in-hospital mortality rate within one-month follow-up.