摘要
Decompressive hemicraniectomy (DC) can save the lives of patients with malignant middle cerebral artery (MCA) infarction. We proposed that postoperative midline shift is important for the long-term outcome of patients with MCA infarction. We conducted a retrospective study of DC in 38 patients with malignant MCA infarction. The long-term outcome was assessed one year after surgery using the modified Rankin Scale (mRS) score. Patients who had midline shift less than the optimal diagnostic cut-off point on the fourth postoperative day were classified as having a successful decompression and the remaining patients were classified in the failed decompression group. The successful decompression group mRS score was 4.20 ± 0.89 one year after surgery and the failed decompression group mRS score was 5.11 ± 0.76 (p < 0.0001). Successful decompression, resulting in postoperative midline shift of less than 5 mm, was a key factor for beneficial, long-term functional outcomes in patients with malignant MCA infarction. © 2011 Elsevier Ltd. All rights reserved.