5. Results of resuscitation treatment of patients with malignant middle cerebral artery infarction with decompressive hemicraniectomy Hanoi Medical University Hospital

Vu Viet Ha, Mai Duy Ton, Nguyen Cong Hoan

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Abstract

Malignant middle cerebral artery infarction is a severe situation with a high mortality rate. The application of patient resuscitation treatments, especially decompressive hemicraniectomy, helps to improve the patient's prognosis. This study evaluated the effectiveness of resuscitation on 53 patients who were diagnosed with cerebral infarction due to malignant middle cerebral artery occlusion and underwent decompressive hemicraniectomy. The mortality rate in our study at the time of discharge was 13.21%, and the mortality rate within 90 days was 22.64%. The rate of patients with good clinical outcomes, mRS 0-3, after 90 days was 39.6%. The surgical timing in the study was 19.4 hours with 69.8% of patients undergoing surgery before 24 hours. After undergoing decompressive craniectomy, 54.7% of patients experienced clinical and radiological improvement. Factors associated with favorable clinical outcomes include being under 60, having a purely middle cerebral artery occlusion, ASPECTs score of 4-6, NIHSS score below 18, and receiving timely reperfusion therapy in golden duration.

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References

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