Malign Orta Serebral Arter İnfarktında Dekompresif Cerrahi

Amaç: Merkezimizde malign Orta serebral arter tıkanıklığı ile takip edilirken dekompresif cerrahi uygulanmış olan hastaları değerlendirmek ve sonuçlarını güncel literatür bilgileriyle karşılaştırarak tartışmak. Gereç ve Yöntem: Ocak 2013-Mayıs 2015 tarihleri arasında İnönü Üniversitesi Turgut Özal Tıp Merkezi Nöroloji kliniğini inme ünitesinde malign Orta serebral arter tanısı almış ve dekompresif cerrahi yapılmış 31 hasta retrospektif olarak değerlendirilmiştir. Bulgular: Hastaların tamamına dekompresyon+duraplasi cerrahi prosedürü uygulandı. 18 kadın, 13 erkek hastanın yaş ortalaması 65,5’ti. Cerrahi uygulanan hastaların en az altı aylık izlem sonunda sağ kalım oranı %29 olarak bulundu. Yaş ≤65 alındığında sağ kalım %50 oranında gözlendi. Sonuç: Mortalite oranı literatür ile karşılaştırıldığında beklenenden yüksek olmakla beraber bu durumun cerrahi için hasta seçiminde kriterlerin daha geniş aralıkta tutulmasından kaynaklandığı düşünülmektedir. İnme için risk faktörü sayısının birden fazla olması ve cerrahiye alınan hastaların yaşının >65 olmasının cerrahi sonrası mortaliteyi istatiksel olarak anlamlı bir şekilde arttırdığı görülmüştür. Uygun hastalarda yapılan dekompresif cerrahi mortaliteyi azaltırken, fonksiyonel anlamda kısmi iyilik hali sağlayabilir.

Decompressive Surgery for Malignant Middle Cerebral Artery Infarctions

Aim: The aim of the study is to evaluate patients who underwent decompressive surgeryfollowed by malignant MCA infarction diagnosis in our center and compare and discuss ourresults with the current literature.Materials and Methods: This is a retrospective evaluation of thirty-one malignant middleserebral artery infarction patients who underwent decompressive surgery and wereadmitted to the Inonu University Turgut Ozal Medical Center, Neurology Clinic Stroke Unitbetween January 2013 and May 2015.Results: All patients underwent decompression + duraplasty procedures. The survival rateof the patients who underwent surgery and were followed for at least six months was 29%.The mean age of 18 women and 13 men patients was 65.5 years. The survival rate was 50%in patients under ≤65.Conclusion: The mortality rate was higher than expected compared with the literaturebecause of the wide range of indications. We observed that multiple risk factors forcerebrovascular diseases and age (above 65) resulted in a statistically significant increase inpostoperative mortality. The decompressive surgery in eligible patients may reducemortality and may provide partial functional well-being.

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