![]() ![]() Received: Accepted: 05 September 2018 Published: 13 September 2018. Keywords: Decompressive craniectomy (DC) meta-analysis outcomes critical care stroke trauma brain injury (TBI) subarachnoid hemorrhage ![]() ![]() Also, it seems that we should ensure that real clinical indications conform to those evaluated in clinical trials. Future studies should incorporate the evaluation of QOL, the institutional coverage and rehabilitation services, economic analysis, and impact of modern neuromonitoring techniques. As rule, the medical protocols do not include monitoring of oxygenation of brain tissue, cerebral microdialysis or electroencephalogram (EEG)-derived parameters.Ĭonclusions: The only clear current indication refers to certain select cases of malignant MCA infarction. Those beneficial effects cannot be demonstrated in the other studied pathologies. However, international records indicate that a different population is being treated with DC. Patients ≤60 years, with infarctions ≥50% of MCA territory, without contralateral involvement, Glasgow Coma Score ≥6 and without bilateral fixed mydriasis, should be considered for early DC. DC reduces mortality or vegetative state (OR 0.21 95% CI, 0.14–0.32) and the combined goal of mortality or moderate-severe disability (OR 0.35 95% CI, 0.21–0.58) at 12 months in a malignant stroke of the middle cerebral artery (MCA). Eleven studies reported modified Rankin Scale and 4 Extended Glasgow Outcome Scale. None of the studies used specific QOL assessments. Results: Fifteen studies (1,603 patients) were included (9 ischemic stroke, 3 trauma brain injury, 3 subarachnoid hemorrhage, none cerebral hemorrhage). Methods: Meta-analysis of randomized controlled trials, cohort and case-control studies. We have performed a systematic review and meta-analysis to study the results in terms of quality of life (QOL) and survival at 1 year of follow-up of patients undergoing this treatment. Policy of Dealing with Allegations of Research Misconductīackground: Primary decompressive craniectomy (DC) is increasingly used in certain neurosurgical pathologies.Policy of Screening for Plagiarism Process. ![]()
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