Decompressive craniectomy versus conservative treatment: limits and possibilities in malignant stroke

Abstract: Background: Malignant infarction of the middle cerebral artery (MCA) occurs in a subgroup of patients with ischemic stroke and early decompressive craniectomy (DC) is one of its treatments. Objective: To investigate the functional outcome of patients with malignant ischemic stroke treated with decompressive craniectomy at a neurological emergency center in Northeastern Brazil. Methods: Prospective cohort study, in which 25 patients were divided into two groups: those undergoing surgical treatment with DC and those who continued to receive standard conservative treatment (CT). Functionality was assessed using the modified Rankin Scale (mRS), at follow-up after six months. Results: A favorable outcome (mRS≤3) was observed in 37.5% of the DC patients and 29.4% of CT patients (p=0.42). Fewer patients who underwent surgical treatment died (25%), compared to those treated conservatively (52.8%); however, with no statistical significance. Nonetheless, the proportion of patients with moderate to severe disability (mRS 4–5) was higher in the surgical group (37.5%) than in the non-surgical group (17.7%). Conclusion: In absolute values, superiority in the effectiveness of DC over CT was perceived, showing that the reduction in mortality was at the expense of increased disability.

Object Details

• Alternative title: Craniectomia descompressiva versus tratamento conservador: limites e possibilidades no AVC maligno
• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Decompressive craniectomy versus conservative treatment: limits and possibilities in malignant stroke ; volume:78 ; number:06 ; year:2020 ; pages:349-356 ; Arquivos de neuro-psiquiatria ; 78, Heft 06 (2020), 349-356

Contributors, Places and Time

• Contributor: MAIA, Isaac Holanda Mendes ; MELO, Thaissa Pinto de ; LIMA, Fabrício Oliveira ; CARVALHO, João José de Freitas ; MONT’ALVERNE, Francisco José Arruda ; LOPES, Edson ; DIÓGENES, Marcelo Bezerra ; CUNHA, Thaís Saraiva Leão ; QUEIROZ, Bárbara Matos Almeida ; TAMIETTI, Marina Franciss ; MAIA, Fernanda Martins

Further information

• DOI: 10.1590/0004-282X20200006
• URN: urn:nbn:de:101:1-2023072710521359737839
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.08.2025, 10:51 AM CEST