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AuthorNeugebauer, Hermanndc.contributor.author
AuthorFiss, Ingodc.contributor.author
AuthorPinczolits, Alexandradc.contributor.author
AuthorHecht, Nils Nicholasdc.contributor.author
AuthorWitsch, Jensdc.contributor.author
AuthorDengler, Noradc.contributor.author
AuthorVajkoczy, Peterdc.contributor.author
AuthorJüttler, Ericdc.contributor.author
AuthorWoitzik, Johannesdc.contributor.author
Date of accession2021-12-06T06:43:05Zdc.date.accessioned
Available in OPARU since2021-12-06T06:43:05Zdc.date.available
Date of first publication2016-02-09dc.date.issued
AbstractBackground: Decompressive hemicraniectomy (DHC) reduces mortality and improves outcome after malignant middle cerebral artery infarction (MMI) but early in-hospital mortality remains high between 22 and 33%. Possibly, this circumstance is driven by cerebral herniation due to space-occupying brain swelling despite decompressive surgery. As the size of the removed bone flap may vary considerably between surgeons, a size too small could foster herniation. Here, we investigated the effect of the additional volume created by an extended DHC (eDHC) on early in-hospital mortality in patients suffering from MMI. Methods: We performed a retrospective single-center cohort study of 97 patients with MMI that were treated either with eDHC (n = 40) or standard DHC (sDHC; n = 57) between January 2006 and June 2012. The primary study end point was defined as in-hospital mortality due to transtentorial herniation. Results: In-hospital mortality due to transtentorial herniation was significantly lower after eDHC (0 vs. 11%; p = 0.04), which was paralleled by a significantly larger volume of the craniectomy (p < 0.001) and less cerebral swelling (eDHC 21% vs. sDHC 25%; p = 0.03). No statistically significant differences were found in surgical or non-surgical complications and postoperative intensive care treatment. Conclusion: Despite a more aggressive surgical approach, eDHC may reduce early in-hospital mortality and limit transtentorial herniation. Prospective studies are warranted to confirm our results and assess general safety of eDHC. © In Copyright http://rightsstatements.org/vocab/InC/1.0/dc.description.abstract
Languageendc.language.iso
PublisherUniversität Ulmdc.publisher
LicenseIn Copyrightdc.rights
Link to license texthttp://rightsstatements.org/vocab/InC/1.0/dc.rights.uri
KeywordMalignant middle cerebral artery infarctiondc.subject
KeywordSpace-occupying edemadc.subject
KeywordHemicraniectomydc.subject
KeywordDecompressive surgerydc.subject
Dewey Decimal GroupDDC 610 / Medicine & healthdc.subject.ddc
MeSHCraniotomydc.subject.mesh
MeSHSkull; Surgerydc.subject.mesh
MeSHCerebrovascular disorders; Surgerydc.subject.mesh
MeSHCerebral infarctiondc.subject.mesh
TitleLarge size hemicraniectomy reduces early herniation in malignant middle cerebral artery infarctiondc.title
Resource typeWissenschaftlicher Artikeldc.type
SWORD Date2019-12-19T17:59:42Zdc.date.updated
VersionpublishedVersiondc.description.version
DOIhttp://dx.doi.org/10.18725/OPARU-40121dc.identifier.doi
URNhttp://nbn-resolving.de/urn:nbn:de:bsz:289-oparu-40197-1dc.identifier.urn
GNDKraniotomie <Schädelchirurgie>dc.subject.gnd
GNDHirninfarktdc.subject.gnd
FacultyMedizinische Fakultätuulm.affiliationGeneral
InstitutionUKU. Klinik für Neurologieuulm.affiliationSpecific
InstitutionRehabilitationskrankenhaus Ulmuulm.affiliationSpecific
Peer reviewjauulm.peerReview
DCMI TypeTextuulm.typeDCMI
CategoryPublikationenuulm.category
In cooperation withCharité, Berlinuulm.cooperation
In cooperation withOstalb-Klinikum Aalenuulm.cooperation
DOI of original publication10.1159/000443935dc.relation1.doi
Source - Title of sourceCerebrovascular Diseasessource.title
Source - Place of publicationKarger Publisherssource.publisher
Source - Volume41source.volume
Source - Issue5-6source.issue
Source - Year2016source.year
Source - From page283source.fromPage
Source - To page290source.toPage
Source - ISSN1015-9770source.identifier.issn
Source - eISSN1421-9786source.identifier.eissn
PubMed26855236uulm.identifier.pubmed
Rights noticeDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.dc.rights.other
Rights noticeThis publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.dc.rights.other
Bibliographyuulmuulm.bibliographie


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