Temporal lobectomy in patients with malignant stroke and raised intracranial pressure after decompressive hemicraniectomy
Year: 2019
Type: article
Study design: Case Report
Abstract: Introduction: Malignant stroke corresponds to 5% of ischemic cerebrovascular disease and it was named due to the high mortality with medical therapy.It is defined by symptoms suggesting stroke of the middle cerebral artery territory, the evolution into a progressive decrease in consciousness level of the patient and a computed tomography that show a stroke which affect at least 50% of middle cerebral artery territory or a volume greater than 145 cc in magnetic resonance.Case report: Three patients with a middle cerebral artery territory stroke, who underwent a decompressive hemicraniectomy in the first 48 hours after the onset of symptoms and posteriorly needed a temporal lobectomy as a life-saving procedure, are reported.Discussion: Malignant stroke has a mortality of 70 to 80% with medical therapy.Decompressive hemicraniectomy addition reduce mortality to 20 -30% and enhance a better functional prognosis.Some authors suggest that the resection of non-viable brain tissue as the first treatment or when the decompressive hemicraniectomy is not enough diminish even more the mortality and provide a better prognosis.In the patients presented, temporal lobectomy when raised intracranial pressure appeared, even after decompressive hemicraniectomy, proven to reduce the mortality.Conclusion: Temporal lobectomy is not a routinely procedure in patients with malignant stroke, but it can be useful in selective patients in whom the decompressive hemicraniectomy in not enough to reduce intracranial pressure.
Source: Journal of Neurology & Stroke
Authors: Maria Veronica Bentancourt, Mariana Romero, Fernando Martinez
Institution: Universidad de la República de Uruguay
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2983479522