The effect of hematoma evacuation with decompressive craniectomy on clinical outcomes in patients with parenchymal hematoma type 2 of hemorrhagic transformation after middle cerebral artery infarction.
Neurol Res
; 44(10): 894-901, 2022 Oct.
Article
em En
| MEDLINE
| ID: mdl-35430951
ABSTRACT
OBJECTIVES:
The purpose of this study was to investigate the feasibility of hematoma evacuation (HE) with decompressive craniectomy (DC) and to evaluate whether HE with DC is associated with improvement of clinical outcomes in patients with parenchymal hematoma type 2 (PH2) after middle cerebral artery (MCA) infarction.METHODS:
Between March 2007 and August 2020, 73 patients with PH2 after MCA infarction underwent DC. The HE group (n = 28) consisted of subjects who underwent HE with DC and the non-HE group (n = 45) consisted of subjects who underwent only DC without HE. The clinical outcomes were analyzed and compared between groups.RESULTS:
Significant differences in clinical outcomes were not observed between the groups at discharge (P = 0.648) and 12-month follow-up (P = 0.346). Mortality rate within 12 months was not significantly different between the groups (log-rank, P = 0.685). There were 12 reoperations in the HE group (42.9%) and three reoperations in the non-HE group (6.7%; P = 0.037). Logistic regression analysis showed the initial National Institutes of Health Stroke Scale score (OR, 2.320; 95% CI, 1.128-5.965; P = 0.046) and the infarction volume (OR, 1.876; 95% CI, 1.935-11.892; P = 0.041) were independently associated with mortality (modified Rankin Scale, 6) within the 12 months.CONCLUSIONS:
In patients with PH2 of hemorrhagic transformation after MCA infarction, HE with DC does not change the clinical outcomes or mortality but might increase the reoperation risk.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infarto da Artéria Cerebral Média
/
Craniectomia Descompressiva
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Neurol Res
Ano de publicação:
2022
Tipo de documento:
Article