Effect of decompressive surgery for the treatment of massive cerebral infarction and analysis of the relative factors

GAO Yafei; CHANG Tao; YANG Yanlong; LI Lihong

Abstract：Objective The effect of decompressive surgery for the treatment of massive cerebral infarction and the factors related to outcomes are discussed.Methods Seventy-one cases with massive cerebral infarction treated in our department between August 2011 and August 2013, were reviewed and analyzed,retrospectively.Fifty-eight cases were treated by surgery while thirteen cases were treated by conservative treatment.The outcomes of two groups were compared and the related faactors were analyzed.Results There was no statistical difference in age, gender, GCS scores on admission between two groups (P>0.05).After treatment, the ratio of survival patients at 1 w (P=0.003) and 6 months (P=0.005) were significant different between two groups;no signficant difference was found in the ratio of poor recovery (mRS>3) between two groups (P=0.081).One month after opertaion, mortality was lower in patients≤60 years (P=0.042) and in patients who were operated within 48 h of stroke onset (P=0.031) with statistical difference between two groups.The ratio of good recovery (mRS≤3) was higher in patients≤60 years (P=0.031) and patients who were operated within 48 h of stroke onset ( P=0.011) at 6 months post-operation. Conclusion Decompressive craniectomy in the treatment of massive cerebral infarction can enhance the curative efficacy at 1 w and 6 months post -operation.However, operation can not improve the life quality at 6 months compared to the conservative treatment.Decompressive surgery undertaken within 48 h of stroke onset in patients younger than 60 years may reduce the mortality and increase the number of patients with a favorable outcome.