We read Qureshi et al's meta-analysis of 7 trials on decompressive hemicraniectomy in large hemispheric ischemic stroke patients with great appreciation.
1The study re-demonstrates the considerable survival and functional outcomes benefit of decompressive hemicraniectomy in patients under the age of 60.
- Qureshi A.I.
- Ishfaq M.F.
- Rahman H.A.
- et al.
Hemicraniectomy versus conservative treatment in large hemispheric ischemic stroke patients: a meta-analysis of randomized controlled trials.
J Stroke Cerebrovasc Dis. 2016; 25: 2209-2214
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- Hemicraniectomy versus conservative treatment in large hemispheric ischemic stroke patients: a meta-analysis of randomized controlled trials.J Stroke Cerebrovasc Dis. 2016; 25: 2209-2214
- Hemicraniectomy in older patients with extensive middle-cerebral-artery stroke.N Engl J Med. 2014; 370: 1091-1100
Published online: November 22, 2016
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
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- Response to Drs. Lahiri and LydenJournal of Stroke and Cerebrovascular DiseasesVol. 26Issue 9
- PreviewWe thank Drs. Lahiri and Lyden for their valuable comments regarding the benefit of hemicraniectomy in patients over the age of 60 years. As the authors mentioned, there was a trend toward higher odds of favorable outcome (modified Rankin Scale scores of 0-3) among those randomized to hemicraniectomy compared with conservative treatment in trials that permitted recruitment of patients aged 60 years or older (303 subjects analyzed; odds ratio 1.87, 95% confidence interval .91-3.86, P = .09). We agree that the data did not support a significant benefit but only a trend toward higher rates of favorable outcomes.