decompressive hemicraniectomy for malignant mca ... - RM Solutions

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Unanswered questions:• How should we define “ good” 0r “favorable”outcome ?• Who should define “good” outcome ?• What are the ethical, religious, culturalconsiderations that may confound outcome ?• What are the social and financial supportsavailable <strong>for</strong> such patients ?6/23/2011 khathaami 26
• Who should be treated with DHC ?- Age- Co-morbidity- Pattern of stroke (multiple vessels)- Dominant vs non-dominant hemisphere.• When should we operate ?- Early vs late- Prediction6/23/2011 khathaami 27
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 and 14: • DECIMAL trial (French)• DESTI
Page 15 and 16: Patients included:• Age 18 - 60 y
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: Complications of DHC:• Immediate
Page 29 and 30: Recommendations:• The surgery sho

decompressive hemicraniectomy for malignant mca ... - RM Solutions

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