decompressive hemicraniectomy for malignant mca ... - RM Solutions

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• Meta-analysis of multicenter, controlledand randomized trials• Two arms: maximal medical therapy<strong>decompressive</strong> surgery• Outcome was assessed blindly in DICEMALby a neurologist, unblinded in DISTENYand independently in HALMET.6/23/2011 khathaami 14
Patients included:• Age 18 – 60 years• Infarction in the territory of the MCA withNIHSS >15• Decrease in the LOC to a score of 1 or greater onitem 1a of the NIHSS6/23/2011 khathaami 15
Page 1: DECOMPRESSIVE HEMICRANIECTOMYFOR MA
Page 5 and 6: CLINICAL MANIFESTATIONS• Reflect
Page 7 and 8: Pathophysiology:• Direct mechanic
Page 9 and 10: CT predictors of malignantcourse an
Page 11 and 12: Chemical predictors of badoutcome
Page 13: • DECIMAL trial (French)• DESTI
Page 17 and 18: Patients excluded• Prestroke mRS
Page 19 and 20: Outcome:• Primary outcome m-RS0 -
Page 21 and 22: increase favorable outcome (m-RS 0-
Page 23 and 24: 6/23/2011 khathaami 23
Page 25 and 26: Complications of DHC:• Immediate
Page 27 and 28: • Who should be treated with DHC
Page 29 and 30: Recommendations:• The surgery sho

decompressive hemicraniectomy for malignant mca ... - RM Solutions

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