Effect of decompressive craniectomy on prognosis, disability and quality of life at patients with malignant hemisferic infarction

Objective: Malignant hemispheric infarctions are severe clinical cases with 80% mortality rates. Conservative treatment options have limited effect on these cases. In this study we aim to determine effect of DC on prognosis, disability and quality of life at patients with malignant hemispheric infarctions also to determine the parameters which have influence on DC. Method: Retrospectively, we investigate 40 patients who underwent DC due to malignant hemispheric infarction at University Hospital of Akdeniz between 2000 and 2015. We investigated patients dermographical, neurological and radiological recordings and their effect on DC. Findings: Hemisphere dominancy, preoperative GCS score, pupillary changes, amount of shift and additional systemic diseases have influence on prognosis. Timing of DC have effect on patient's postoperative disabilities. Age and timing of DC have influence on patient's postoperative daily life activities. Timing of DC and existence of additional systemic diseases have influence on patient's quality of life. Results: Hemisphere dominancy, preoperative GCS score, pupillary changes, amount of shift and additional systemic diseases have positive effect on prognosis (GOS). Early DC has positive influence on patient's postoperative disabilities. Young age and early DC improves patient's daily life activities. Patient's with additional systemic diseases have higher tolerance to pain. Patients who undergone early DC have better quality of life in terms of vitality, general health status and physical functioning