They were randomly assigned to receive either conservative treatment in the intensive care unit or hemicraniectomy within 48 hours of the start of symptoms. They all had ischemic strokes affecting the middle cerebral artery. The current study included 112 people aged 61 and older, with an average age of 70. In younger people, hemicraniectomy-when done within the first 48 hours after a stroke-leads to better survival rates and less severe disability.īut, because most strokes occur in those over 60, the researchers wanted to know if hemicraniectomy offered the same benefits to older people. Previous research has focused on hemicraniectomy in people under 60 who've had a stroke. This procedure is called hemicraniectomy. One way of relieving that pressure is to remove (and eventually replace) a portion of the skull above the affected brain tissue. Allan Ropper, executive vice chair of neurology at Brigham and Women's Hospital, in Boston. This occurs in about 5 percent of strokes, according to the author of an accompanying editorial, Dr. When swelling is severe, the brain starts to compress as it reaches the skull. Ischemic stroke, which occurs when a blood vessel in the brain is blocked, is the type researchers looked at in this study.ĭuring a large ischemic stroke, one possible complication is brain swelling. There are two types of stroke: hemorrhagic and ischemic stroke, the second of which is far more common. Results of the study are published in the March 20 issue of the New England Journal of Medicine. "Some of these older stroke survivors do have a severe disability, which may require help in most daily activities," added Hacke, a professor of neurology and chairman of the neurological center at the University of Heidelberg, in Germany. Seventy percent survive with surgery, only 30 percent without," said senior study author Dr. "Hemicraniectomy in malignant middle cerebral artery stroke, which is proven lifesaving and prevents severe disabilities in patients under 60, remains lifesaving in elderly patients with malignant. Unfortunately, even though the procedure-called hemicraniectomy-reduces pressure on a swelling brain, the surgery doesn't prevent disability caused by the stroke.
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