Effect of decompressive partial temporal lobectomy on extensive panhemispheric infarction of middle cerebral artery with impending herniation process

J Korean Neurol Assoc > Volume 15(1); 1997 > Article

Journal of the Korean Neurological Association 1997;15(1): 46-53.

편측 중대뇌동맥의 광범위 뇌경색에서 시행한 측두업 부분절제술의 효과

윤혜정, 권오영, 임병훈, 김경원, 박인성, 정진명

경상대학교 의대 신경과. 신경외과

Effect of decompressive partial temporal lobectomy on extensive panhemispheric infarction of middle cerebral artery with impending herniation process

Hae-Jeong Yun, M.D., Oh-Young Kwon, M.D., Byeong-Hoon Lim, M.D., Gyeong Won Kim, M.D., In-Sung Park, M.D., Jin-Myung Jung, M.D.

Department of Neurology, Neurosurgery, Gyeongsang National University College of Medicine.

Abstract

Acute infarction in the whole territory of the middle cerebral artery (MCA) can lead to massive cerebral edema, raised intracranial pressure and cerebral herniation which may result in come and death ultimately. There are same reports which mentioned that craniectomy or stroketomy was an effective life-saving procedure and favorable outcome would be expected after the procedure. In this study, the effect of decompressive partial temporal lobectomy was evaluated in twelve patients of extensive panhemispheric infarction of middle cerebral artery(MCA). We investigated radiologically proven patients of extensive panhemispheric infarction of MCA with impending herniation process, who were admitted to our hospital from March 1991 to June 1996, prospectively and retrospectively. Decompressive partial temporal lobectomy was performed in twelve patients and eighteen patients were treated by only conventional medical treatment(control group). Prognosis were compared between two groups to analyse the effect of the decompressive lobectomy. Fourteen out of the 18 controls(78%) and five out of 12 patients who were treated by decompressive lobectomy(41%) expired due to herniation process. The mortality between two groups was significantly different(P(0.05). Four patient had relatively good outcome(by Barthel index score) and all of them belonged to the decompressive lobectomy group. These results suggest that the decompressive lobectomy be an effective life saving procedure for malignant cerebral edema after a total MCA infarction.