Outcome Following Decompressive Craniectomy for Malignant Middle Cerebral Artery Infarction in Patients

Objective: Malignant middle cerebral artery (MCA) infarction occurs in 10 % of all ischemic strokes and these severe strokes are associated with high mortality rates. Recent clinical trials demonstrated that early decompressive craniectomy re-duce mortality rates and improves functional outcomes in healthy young patients (less than 61 years of age) with a malignant infarction. The purpose of this study was to assess the efficacy of decompressive craniectomy in elderly patients (older than 70 years of age) with a malignant MCA infarction. Methods: Between February 2008 and October 2011, 131 patients were diag-nosed with malignant MCA infarctions. We divided these patients into two groups: patients who underwent decompressive craniectomy (n = 58) and those who underwent conservative care (n = 73). A cut-off point of 70 years of age was set, and the study population was segregated into those who fell above or below this point. Mortality rates and functional outcome scores were assessed, and a modified Rankin Scale (mRS) score of> 3 was considered to represent a poor outcome