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Health status and life satisfaction after decompressive craniectomy for malignant middle cerebral artery infarction

Journal article
Authors Thomas Skoglund
Catherine Eriksson-Ritzén
Ann Sörbo
Christer Jensen
Bertil Rydenhag
Published in Acta Neurologica Scandinavica
Volume 117
Issue 5
Pages 305-10
ISSN 1600-0404
Publication year 2008
Published at
Pages 305-10
Language en
Keywords Hemicraniectomy, Adult, Aged, Craniotomy/*methods, Decompression, Surgical/*methods, Female, Glasgow Outcome Scale, *Health Status, Humans, Infarction, Middle Cerebral Artery/*psychology/*surgery, Longitudinal Studies, Male, Middle Aged, *Personal Satisfaction, Quality of Life/psychology, Treatment Outcome
Subject categories Neurosurgery


Objectives - To study the long-term outcome in patients with malignant middle cerebral artery (MCA) infarction treated with decompressive craniectomy. The outcome is described in terms of survival, impairment, disabilities and life satisfaction. Materials and methods - Patients were examined at a minimum of 1 year (mean 2.9, range 1-6) after the surgery and classified according to the Glasgow Outcome Scale (GOS), the National Institutes of Health Stroke scale (NIHSS), the Barthel Index (BI), the short-form health survey (SF-36) and the life satisfaction checklist (LiSat-11). Results - Eighteen patients were included. The long-term survival was 78%. The mean NIHSS score was 13.8 (range 6-20). No patient was left in a vegetative state. The mean BI was 63.9 (5-100). The SF-36 scores showed that the patients' view of their health was significantly lower in most items compared with that of a reference group. According to the LiSat checklist, 83% found their life satisfying/rather satisfying and 17% found their life rather dissatisfying/dissatisfying. Conclusion - We conclude that the patients remained in an impaired neurological condition, but had fairly good insight into their limitations. Although their life satisfaction was lower compared with that of the controls, the majority felt that life in general could still be satisfying.

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