Assessing the effect of decopmression surgery performed due to malignant ischemic stroke on the quality of life

Öz

Aim: Decompressive craniectomy is one of the treatment methods that reduces mortality, when used in eligible patients for the treatment of malignant ischemic stroke (MIS). In this study, we

aimed to assess the effect of age and the timing of surgery on the quality of life and on the prognosis of patients that underwent decompressive craniectomy.

Material and Method: The files of 45 patients between the ages of 24-98, who were recommended decompressive craniectomy in connection with malignant ischemic stroke, were reviewed within the scope of the study. Result: 27 (60%) patients, who agreed to undergoing surgery, and 18 (40%) patients, who did not agree to undergoing surgery, were taken under review. A significant improvement (between 0 and 3) was observed in the modified Rankin Scale Scores of the two patients that underwent surgery. All the patients (n = 4) from within the group of patients that did not agree to a surgery, who lived for more than 6 months, were found to have a modified Rankin Scale Score of 5 and needed support to fulfill their daily life activities. Conclusion: It has been observed that performing a decompressive craniectomy after 72 hours following clinical deterioration and radiological shift did not have a significant effect on mortality and morbidity. Studies with larger patient groups are needed to be carried out in order to determine the applicability criteria of surgical treatment.

Anahtar Kelimeler

• stroke
• decompressive craniectomy
• prognosis
• mortality

Malign iskemik inmede dekompresyon cerrahinin yaşam kalitesi üzerine etkisinin değerlendirilmesi

Öz

Amaç: Dekompressif kraniektomi malign iskemik inme tedavisinde uygun hastalarda kullanıldığında mortaliteyi azaltan tedavi yöntemlerinden biridir. Çalışmamızda dekompressif

kraniektomi yapılan hastalarda operasyon zamanı ve yaşın, yaşam kalitesi ve prognoz üzerine etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Malign iskemik inme nedeni ile dekompressif kraniektomi önerilen 24-98 yaş aralığında, 45 hastanın dosyası incelendi. Hastalar cerrahi yapılan ve cerrahiyi kabul etmeyerek sadece konservatif tedavi uygulanan iki gruba ayrılarak değerlendirildi. Bulgular: Operasyonu kabul eden n=27 (%60) hasta ve operasyonu kabul etmeyen n=18 (%40) hasta incelendi. Cerrahi yapılan grupta iki hastanın modifiye Rankin Skorunda belirgin iyileşme görüldü (0-3 arasında). Cerrahiyi kabul etmeyen grupta 6 aydan uzun süre yaşayan hastaların hepsinde (n=4) modifiye Rankin Skoru: 5 olup günlük yaşam aktivitelerinde desteğe ihtiyaçları vardı.Sonuç: Klinik kötüleşme ve radyolojik olarak şift görüldükten 72 saat sonra yapılan dekompresif kraniektominin mortalite ve morbidite üzerinde anlamlı bir etkisinin olmadığı görülmektedir. Cerrahi tedavinin uygulanabilirlik kriterlerini belirlemek için daha büyük hasta grupları ile yapılacak çalışmalara ihtiyaç vardır. 

Anahtar Kelimeler

• iskemik inme
• dekompresyon kraniektomi
• prognoz
• mortalite

Kaynakça

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