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Hemicraniectomy for large middle cerebral artery territory infarction: do these patients really benefit from this procedure?
  1. I E Sandalcioglu1,
  2. B Schoch1,
  3. F Rauhut1
  1. 1Universitatsklinikum Essen, Neurochirurgische Klinik, Hufelandstr 55, 45122 Essen, Germany
  1. Correspondence to: 
 Dr I E Sandalcioglu; 
 sandalciogluuni-essen.de

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Pranesh et al presented a series of 19 patients undergoing decompressive hemicraniectomy for large middle cerebral artery infarction with clinical and radiological signs of transtentorial herniation.1 Among these, 10 patients (53%) suffered from a dominant hemisphere stroke. Neurological state was assessed according to the National Institutes of Health Stroke scale (NIHSS) initially and one week after surgery, and functional outcome at three months' follow up using the Barthel index (BI) and Rankin scale (RS). The mean NIHSS score improved from 20.5 before surgery to 10.5 postoperatively. At last follow up mean BI was significantly better in younger patients (60.7) than in older patients (41.3). The authors conclude that hemicraniectomy may …

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