Hemicraniectomy in Older Stroke Patients

Abstract

Middle cerebral artery (MCA) territory infarcts with life-threatening edema — previously termed “malignant” MCA infarcts — carry a mortality rate as high as 80%. Hemicraniectomy (HC) is a surgical treatment option that allows pressure gradients to be directed outward instead of toward the brainstem, thereby potentially preventing brain herniation. In patients younger than 60, HC substantially reduces mortality without increasing the rate of severe disability. To evaluate whether older patients would also benefit from HC, investigators randomized …