decompressive hemicraniectomy for malignant mca ... - RM Solutions

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Recommendations:• Anticipate the problem. Patients who is potential <strong>for</strong>MMCA infarct should be monitored closely and has afollow up CT in 12 -24 hrs. Early neurosurgery Consultationis encouraged.• DHC should be offered to patients < 60 years old with nosignificant co-morbidities with clinical & radiologicalfeatures consistent with MMCA.6/23/2011 khathaami 28
Recommendations:• The surgery should be within 48 hrs ofstroke onset. Do not wait <strong>for</strong> the fully“blown pupils”• The is no evidence to exclude patientswith ACA infarct or dominant hemisphere.• Involve Family in the decision making.6/23/2011 khathaami 29
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 and 26: Complications of DHC:• Immediate
Page 27: • Who should be treated with DHC

decompressive hemicraniectomy for malignant mca ... - RM Solutions

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