REVIEW  NEUROSURGICAL MANAGEMENT AND INTERVENTION OF ISCHEMIC STROKE 

Journal of Neurosurgical Sciences 2021 June;65(3):249-58

DOI: 10.23736/S0390-5616.20.05103-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Decompressive hemicraniectomy in ischemic stroke

Friedrich MROSK, Nils HECHT ✉, Peter VAJKOCZY

Department of Neurosurgery, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany

Malignant hemispheric stroke (MHS) is a life-threatening event, associated with high morbidity and mortality. Decompressive hemicraniectomy (DHS) is the treatment of choice to relieve the emerging space-occupying brain edema. This review details the pathophysiological and scientific background, considerations for clinical decision making, surgical treatment and impact on the patients’ outcome. Although surgery reduces mortality significantly, the probability for unfavorable outcome is still high in selected cases. While former randomized controlled studies aimed for the prevention of the primary cause, the current research focuses on the treatment and prevention of secondary neurological injury.

KEY WORDS: Decompressive craniectomy; Stroke; Decision making; Quality of life