The course of massive ischemic stroke (MIS) was studied in 105 patients. The results of investigations and intensive treatment identified a group of patients in which the course of MIS was benign, with no development of dislocation syndrome, and a group with a malignant course, with development of hemisphere cerebral edema and further transtentorial impact. Risk factors for the development of the malignant form of MIS and lethal outcomes were identified: lateral dislocation of greater than 7 mm, volume of ischemia greater than 70% of the frontal and parietal lobes and more than 80% of the temporal lobe, and impairment to the level of consciousness to moderate coma and worse. These were used to form a group of patients who underwent decompression craniotomy on the side of the lesioned hemisphere. This decreased lethality more than twofold compared with patients treated conservatively.
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Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 113, No. 1, Iss. I, pp. 15–22, January, 2013.
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Krylov, V.V., Nikitin, A.S., Burov, S.A. et al. Decompression Craniotomy in the Complex Intensive Therapy of Malignant Forms of Massive Ischemic Stroke. Neurosci Behav Physi 44, 323–330 (2014). https://doi.org/10.1007/s11055-014-9913-6
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DOI: https://doi.org/10.1007/s11055-014-9913-6