Comparison of the decompressive surgery and medical therapy alone results in malignant middle cerebral artery infarction [Geniş orta serebral arter infarktında dekompresif cerrahi ve yalnızca medikal tedavi sonuçlarının karşılaştırılması]

Decompressive craniectomy is performed in the treatment of malignant middle cerebral artery (mca) infarction as an alternative to medical treatment. the purpose of this cross-sectional trial is to compare the differences in morbidity and mortality rates of malignant mca infarctions with decompressive surgery in comparison to conservative medical therapy alone (standard antiedema treatment). the cases of malignant mca infarctions observed and enrolled in this study were located in our hospital between november 2007 and june 2011. ages of the 42 patients in the trial varied between 40 and 80,20 of the patients were treated with decompressive craniectomy and 22 with medical therapy. rates of survival for patients who were under 60 years old and treated with decompressive craniectomy were significantly higher than those above 60 (p<0.05). the survival rate of the patients who were treated within 6 hours after the onset of symptoms,especially within the surgery group,was significantly higher (p<0.05). at the end of the first months,the survival rate of the cases who were treated with decompressive craniectomy within 48 hours of stroke onset was 50%,after 48 hours of stroke onset was 33%. overall,survival rates in the decompressive craniectomy group were higher when compared with the medical treatment group. decompressive craniectomy should be considered in cases where the patient is younger than 60 and surgery can be performed within 48 hours from the onset of symptoms as it decreases the rates of mortality and morbidity. © 2016,ege university press. all rights reserved.