• J Clin Neurosci · Aug 2011

    Review

    Decompressive craniectomy for malignant middle cerebral artery infarction: evidence and controversies.

    • Reuben D Johnson, Nicholas F Maartens, and Peter J Teddy.
    • Department of Neurosurgery, Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050, Australia. reubenjohnson@doctors.org.uk
    • J Clin Neurosci. 2011 Aug 1; 18 (8): 1018-22.

    AbstractMalignant middle cerebral artery (MCA) infarction (MMI) is associated with a mortality rate of 80%. Decompressive craniectomy is considered a life-saving procedure for patients with this devastating condition. Preclinical and clinical data suggest that this procedure should be undertaken as early as possible, prompting increasing demand for emergency surgery. This article reviews the pathophysiology of MMI, and the experimental and clinical evidence supporting this procedure. We consider some of the controversies surrounding patient selection for this procedure and discuss the role of intracranial pressure monitoring in MMI.Copyright © 2011 Elsevier Ltd. All rights reserved.

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