Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke: South Asian Experience

Background The randomized trials showed improved outcome and reduced mortality in malignant middle cerebral artery (MMCA) undergoing Decompressive hemicraniectomy (DHC) within 48 hours of stroke onset. Despite high prevalence of stroke, especially in younger individuals, high and short-term mortalit...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of stroke and cerebrovascular diseases 2017-10, Vol.26 (10), p.2306-2312
Hauptverfasser: Kamran, Saadat, MD, Akhtar, Naveed, MD, Salam, Abdul, PhD, Alboudi, Ayman, MSc, Rashid, Hiba, MD, Kamran, Kainat, BSc, Khan, Rabia Ali, BSc, Mirza, Mohsin Khalid, MD, Ahmed, Arsalan, MD, Own, Ahmed M.A., MD, Al Rukun, Sohail, FRCPC, Inshasi, Jihad, FRCP, Deleu, Dirk, MD, FRCP, PhD, Al Sulaiti, Ghanim, FRCPC, Shuaib, Ashfaq, FRCPC
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 2312
container_issue 10
container_start_page 2306
container_title Journal of stroke and cerebrovascular diseases
container_volume 26
creator Kamran, Saadat, MD
Akhtar, Naveed, MD
Salam, Abdul, PhD
Alboudi, Ayman, MSc
Rashid, Hiba, MD
Kamran, Kainat, BSc
Khan, Rabia Ali, BSc
Mirza, Mohsin Khalid, MD
Ahmed, Arsalan, MD
Own, Ahmed M.A., MD
Al Rukun, Sohail, FRCPC
Inshasi, Jihad, FRCP
Deleu, Dirk, MD, FRCP, PhD
Al Sulaiti, Ghanim, FRCPC
Shuaib, Ashfaq, FRCPC
description Background The randomized trials showed improved outcome and reduced mortality in malignant middle cerebral artery (MMCA) undergoing Decompressive hemicraniectomy (DHC) within 48 hours of stroke onset. Despite high prevalence of stroke, especially in younger individuals, high and short-term mortality from stroke in South Asian and Middle East, there is little published data on DHC in patients with MMCA stroke. Methods This is a retrospective, multicenter cross-sectional study to measure outcome following DHC using the modified Rankin Scale (mRS) and dichotomized as favorable (mRS ≤ 4) or unfavorable (mRS > 4), at 3 months. Results In total, 137 patients underwent DHC. At 90 days, mortality was 16.8%; 61.3% of patients survived with an mRS of 4 or less and 38.7% had an mRS greater than 4. Age (55 years), diabetes ( P  = .004), hypertension ( P  = .021), pupillary abnormality ( P  = .048), uncal herniation ( P  = .007), temporal lobe involvement ( P  = .016), additional infarction (MCA + anterior cerebral artery, posterior cerebral artery) ( P  = .001), and infarction growth rates ( P  = .025) were significantly higher in patients with unfavorable prognosis in univariate analysis. Multivariate analysis showed age, additional infarction, septum pellucidum deviation greater than 1 cm, and uncal herniation to be associated with a significantly poor prognosis. Time to surgery had no impact on outcome ( P  = .109). Conclusions Similar to the results of the studies from the West, DHC Improves functional outcome in predominantly South Asian patients with MMCA Stroke.
doi_str_mv 10.1016/j.jstrokecerebrovasdis.2017.05.018
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1906145755</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1052305717302379</els_id><sourcerecordid>1906145755</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-8e913ee582cf95d5e17a296ba02d60baf8f5a7dd2b97a789075abe67dad2222b3</originalsourceid><addsrcrecordid>eNqVkUFv1DAQhS1ERUvhLyAfEVJS2-nEDgek7VJopa04LJwtx56A0yRe7GTF_nuyu20PFRfmMnN4em_mG0I-cJZzxsuLNm_TGMM9WoxYx7A1yfmUC8ZlziBnXL0gZxwKkSng_OU8MxBZwUCektcptYxxDgpekVOhQFbA1Bkxn9GGfhMxJb9FeoO9t9EMHu0Y-h1tQqR3pvM_BzOM9M471yFdHuJNRxdxxLij68NSH-k6TOMvukjeDPT6zwajx8HiG3LSmC7h24d-Tn58uf6-vMlW377eLherzF5CNWYKK14gghK2qcABcmlEVdaGCVey2jSqASOdE3UljVQVk2BqLKUzTsxVF-fk_dF3E8PvCdOoe58sdp0ZMExJ84qV_BIkwCy9OkptDClFbPQm-t7EneZM71HrVv8Ltd6j1gz0jHo2efeQN9U9uieLR7azYHUU4Hz11mPUyR6IOB9nvNoF_395n57Z2c4P3pruHneY2jDFYearuU5CM73eP3__ey4LJgpZFX8BDd-02w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1906145755</pqid></control><display><type>article</type><title>Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke: South Asian Experience</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Kamran, Saadat, MD ; Akhtar, Naveed, MD ; Salam, Abdul, PhD ; Alboudi, Ayman, MSc ; Rashid, Hiba, MD ; Kamran, Kainat, BSc ; Khan, Rabia Ali, BSc ; Mirza, Mohsin Khalid, MD ; Ahmed, Arsalan, MD ; Own, Ahmed M.A., MD ; Al Rukun, Sohail, FRCPC ; Inshasi, Jihad, FRCP ; Deleu, Dirk, MD, FRCP, PhD ; Al Sulaiti, Ghanim, FRCPC ; Shuaib, Ashfaq, FRCPC</creator><creatorcontrib>Kamran, Saadat, MD ; Akhtar, Naveed, MD ; Salam, Abdul, PhD ; Alboudi, Ayman, MSc ; Rashid, Hiba, MD ; Kamran, Kainat, BSc ; Khan, Rabia Ali, BSc ; Mirza, Mohsin Khalid, MD ; Ahmed, Arsalan, MD ; Own, Ahmed M.A., MD ; Al Rukun, Sohail, FRCPC ; Inshasi, Jihad, FRCP ; Deleu, Dirk, MD, FRCP, PhD ; Al Sulaiti, Ghanim, FRCPC ; Shuaib, Ashfaq, FRCPC</creatorcontrib><description>Background The randomized trials showed improved outcome and reduced mortality in malignant middle cerebral artery (MMCA) undergoing Decompressive hemicraniectomy (DHC) within 48 hours of stroke onset. Despite high prevalence of stroke, especially in younger individuals, high and short-term mortality from stroke in South Asian and Middle East, there is little published data on DHC in patients with MMCA stroke. Methods This is a retrospective, multicenter cross-sectional study to measure outcome following DHC using the modified Rankin Scale (mRS) and dichotomized as favorable (mRS ≤ 4) or unfavorable (mRS &gt; 4), at 3 months. Results In total, 137 patients underwent DHC. At 90 days, mortality was 16.8%; 61.3% of patients survived with an mRS of 4 or less and 38.7% had an mRS greater than 4. Age (55 years), diabetes ( P  = .004), hypertension ( P  = .021), pupillary abnormality ( P  = .048), uncal herniation ( P  = .007), temporal lobe involvement ( P  = .016), additional infarction (MCA + anterior cerebral artery, posterior cerebral artery) ( P  = .001), and infarction growth rates ( P  = .025) were significantly higher in patients with unfavorable prognosis in univariate analysis. Multivariate analysis showed age, additional infarction, septum pellucidum deviation greater than 1 cm, and uncal herniation to be associated with a significantly poor prognosis. Time to surgery had no impact on outcome ( P  = .109). Conclusions Similar to the results of the studies from the West, DHC Improves functional outcome in predominantly South Asian patients with MMCA Stroke.</description><identifier>ISSN: 1052-3057</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2017.05.018</identifier><identifier>PMID: 28579508</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiovascular ; Comorbidity ; Cross-Sectional Studies ; Decompressive Craniectomy - methods ; decompressive hemicraniectomy ; Female ; Humans ; Infarction, Middle Cerebral Artery - mortality ; Infarction, Middle Cerebral Artery - surgery ; Logistic Models ; Male ; Malignant middle cerebral artery ; Middle Aged ; mRS ; Multivariate Analysis ; Neurology ; Pakistan ; prognosis and outcomes ; Qatar ; Retrospective Studies ; Severity of Illness Index ; Time-to-Treatment ; Treatment Outcome ; United Arab Emirates</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2017-10, Vol.26 (10), p.2306-2312</ispartof><rights>National Stroke Association</rights><rights>2017 National Stroke Association</rights><rights>Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-8e913ee582cf95d5e17a296ba02d60baf8f5a7dd2b97a789075abe67dad2222b3</citedby><cites>FETCH-LOGICAL-c459t-8e913ee582cf95d5e17a296ba02d60baf8f5a7dd2b97a789075abe67dad2222b3</cites><orcidid>0000-0002-0260-2086</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.05.018$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28579508$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kamran, Saadat, MD</creatorcontrib><creatorcontrib>Akhtar, Naveed, MD</creatorcontrib><creatorcontrib>Salam, Abdul, PhD</creatorcontrib><creatorcontrib>Alboudi, Ayman, MSc</creatorcontrib><creatorcontrib>Rashid, Hiba, MD</creatorcontrib><creatorcontrib>Kamran, Kainat, BSc</creatorcontrib><creatorcontrib>Khan, Rabia Ali, BSc</creatorcontrib><creatorcontrib>Mirza, Mohsin Khalid, MD</creatorcontrib><creatorcontrib>Ahmed, Arsalan, MD</creatorcontrib><creatorcontrib>Own, Ahmed M.A., MD</creatorcontrib><creatorcontrib>Al Rukun, Sohail, FRCPC</creatorcontrib><creatorcontrib>Inshasi, Jihad, FRCP</creatorcontrib><creatorcontrib>Deleu, Dirk, MD, FRCP, PhD</creatorcontrib><creatorcontrib>Al Sulaiti, Ghanim, FRCPC</creatorcontrib><creatorcontrib>Shuaib, Ashfaq, FRCPC</creatorcontrib><title>Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke: South Asian Experience</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>Background The randomized trials showed improved outcome and reduced mortality in malignant middle cerebral artery (MMCA) undergoing Decompressive hemicraniectomy (DHC) within 48 hours of stroke onset. Despite high prevalence of stroke, especially in younger individuals, high and short-term mortality from stroke in South Asian and Middle East, there is little published data on DHC in patients with MMCA stroke. Methods This is a retrospective, multicenter cross-sectional study to measure outcome following DHC using the modified Rankin Scale (mRS) and dichotomized as favorable (mRS ≤ 4) or unfavorable (mRS &gt; 4), at 3 months. Results In total, 137 patients underwent DHC. At 90 days, mortality was 16.8%; 61.3% of patients survived with an mRS of 4 or less and 38.7% had an mRS greater than 4. Age (55 years), diabetes ( P  = .004), hypertension ( P  = .021), pupillary abnormality ( P  = .048), uncal herniation ( P  = .007), temporal lobe involvement ( P  = .016), additional infarction (MCA + anterior cerebral artery, posterior cerebral artery) ( P  = .001), and infarction growth rates ( P  = .025) were significantly higher in patients with unfavorable prognosis in univariate analysis. Multivariate analysis showed age, additional infarction, septum pellucidum deviation greater than 1 cm, and uncal herniation to be associated with a significantly poor prognosis. Time to surgery had no impact on outcome ( P  = .109). Conclusions Similar to the results of the studies from the West, DHC Improves functional outcome in predominantly South Asian patients with MMCA Stroke.</description><subject>Cardiovascular</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Decompressive Craniectomy - methods</subject><subject>decompressive hemicraniectomy</subject><subject>Female</subject><subject>Humans</subject><subject>Infarction, Middle Cerebral Artery - mortality</subject><subject>Infarction, Middle Cerebral Artery - surgery</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Malignant middle cerebral artery</subject><subject>Middle Aged</subject><subject>mRS</subject><subject>Multivariate Analysis</subject><subject>Neurology</subject><subject>Pakistan</subject><subject>prognosis and outcomes</subject><subject>Qatar</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Time-to-Treatment</subject><subject>Treatment Outcome</subject><subject>United Arab Emirates</subject><issn>1052-3057</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkUFv1DAQhS1ERUvhLyAfEVJS2-nEDgek7VJopa04LJwtx56A0yRe7GTF_nuyu20PFRfmMnN4em_mG0I-cJZzxsuLNm_TGMM9WoxYx7A1yfmUC8ZlziBnXL0gZxwKkSng_OU8MxBZwUCektcptYxxDgpekVOhQFbA1Bkxn9GGfhMxJb9FeoO9t9EMHu0Y-h1tQqR3pvM_BzOM9M471yFdHuJNRxdxxLij68NSH-k6TOMvukjeDPT6zwajx8HiG3LSmC7h24d-Tn58uf6-vMlW377eLherzF5CNWYKK14gghK2qcABcmlEVdaGCVey2jSqASOdE3UljVQVk2BqLKUzTsxVF-fk_dF3E8PvCdOoe58sdp0ZMExJ84qV_BIkwCy9OkptDClFbPQm-t7EneZM71HrVv8Ltd6j1gz0jHo2efeQN9U9uieLR7azYHUU4Hz11mPUyR6IOB9nvNoF_395n57Z2c4P3pruHneY2jDFYearuU5CM73eP3__ey4LJgpZFX8BDd-02w</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Kamran, Saadat, MD</creator><creator>Akhtar, Naveed, MD</creator><creator>Salam, Abdul, PhD</creator><creator>Alboudi, Ayman, MSc</creator><creator>Rashid, Hiba, MD</creator><creator>Kamran, Kainat, BSc</creator><creator>Khan, Rabia Ali, BSc</creator><creator>Mirza, Mohsin Khalid, MD</creator><creator>Ahmed, Arsalan, MD</creator><creator>Own, Ahmed M.A., MD</creator><creator>Al Rukun, Sohail, FRCPC</creator><creator>Inshasi, Jihad, FRCP</creator><creator>Deleu, Dirk, MD, FRCP, PhD</creator><creator>Al Sulaiti, Ghanim, FRCPC</creator><creator>Shuaib, Ashfaq, FRCPC</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0260-2086</orcidid></search><sort><creationdate>20171001</creationdate><title>Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke: South Asian Experience</title><author>Kamran, Saadat, MD ; Akhtar, Naveed, MD ; Salam, Abdul, PhD ; Alboudi, Ayman, MSc ; Rashid, Hiba, MD ; Kamran, Kainat, BSc ; Khan, Rabia Ali, BSc ; Mirza, Mohsin Khalid, MD ; Ahmed, Arsalan, MD ; Own, Ahmed M.A., MD ; Al Rukun, Sohail, FRCPC ; Inshasi, Jihad, FRCP ; Deleu, Dirk, MD, FRCP, PhD ; Al Sulaiti, Ghanim, FRCPC ; Shuaib, Ashfaq, FRCPC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-8e913ee582cf95d5e17a296ba02d60baf8f5a7dd2b97a789075abe67dad2222b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Cardiovascular</topic><topic>Comorbidity</topic><topic>Cross-Sectional Studies</topic><topic>Decompressive Craniectomy - methods</topic><topic>decompressive hemicraniectomy</topic><topic>Female</topic><topic>Humans</topic><topic>Infarction, Middle Cerebral Artery - mortality</topic><topic>Infarction, Middle Cerebral Artery - surgery</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Malignant middle cerebral artery</topic><topic>Middle Aged</topic><topic>mRS</topic><topic>Multivariate Analysis</topic><topic>Neurology</topic><topic>Pakistan</topic><topic>prognosis and outcomes</topic><topic>Qatar</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Time-to-Treatment</topic><topic>Treatment Outcome</topic><topic>United Arab Emirates</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kamran, Saadat, MD</creatorcontrib><creatorcontrib>Akhtar, Naveed, MD</creatorcontrib><creatorcontrib>Salam, Abdul, PhD</creatorcontrib><creatorcontrib>Alboudi, Ayman, MSc</creatorcontrib><creatorcontrib>Rashid, Hiba, MD</creatorcontrib><creatorcontrib>Kamran, Kainat, BSc</creatorcontrib><creatorcontrib>Khan, Rabia Ali, BSc</creatorcontrib><creatorcontrib>Mirza, Mohsin Khalid, MD</creatorcontrib><creatorcontrib>Ahmed, Arsalan, MD</creatorcontrib><creatorcontrib>Own, Ahmed M.A., MD</creatorcontrib><creatorcontrib>Al Rukun, Sohail, FRCPC</creatorcontrib><creatorcontrib>Inshasi, Jihad, FRCP</creatorcontrib><creatorcontrib>Deleu, Dirk, MD, FRCP, PhD</creatorcontrib><creatorcontrib>Al Sulaiti, Ghanim, FRCPC</creatorcontrib><creatorcontrib>Shuaib, Ashfaq, FRCPC</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of stroke and cerebrovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kamran, Saadat, MD</au><au>Akhtar, Naveed, MD</au><au>Salam, Abdul, PhD</au><au>Alboudi, Ayman, MSc</au><au>Rashid, Hiba, MD</au><au>Kamran, Kainat, BSc</au><au>Khan, Rabia Ali, BSc</au><au>Mirza, Mohsin Khalid, MD</au><au>Ahmed, Arsalan, MD</au><au>Own, Ahmed M.A., MD</au><au>Al Rukun, Sohail, FRCPC</au><au>Inshasi, Jihad, FRCP</au><au>Deleu, Dirk, MD, FRCP, PhD</au><au>Al Sulaiti, Ghanim, FRCPC</au><au>Shuaib, Ashfaq, FRCPC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke: South Asian Experience</atitle><jtitle>Journal of stroke and cerebrovascular diseases</jtitle><addtitle>J Stroke Cerebrovasc Dis</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>26</volume><issue>10</issue><spage>2306</spage><epage>2312</epage><pages>2306-2312</pages><issn>1052-3057</issn><eissn>1532-8511</eissn><abstract>Background The randomized trials showed improved outcome and reduced mortality in malignant middle cerebral artery (MMCA) undergoing Decompressive hemicraniectomy (DHC) within 48 hours of stroke onset. Despite high prevalence of stroke, especially in younger individuals, high and short-term mortality from stroke in South Asian and Middle East, there is little published data on DHC in patients with MMCA stroke. Methods This is a retrospective, multicenter cross-sectional study to measure outcome following DHC using the modified Rankin Scale (mRS) and dichotomized as favorable (mRS ≤ 4) or unfavorable (mRS &gt; 4), at 3 months. Results In total, 137 patients underwent DHC. At 90 days, mortality was 16.8%; 61.3% of patients survived with an mRS of 4 or less and 38.7% had an mRS greater than 4. Age (55 years), diabetes ( P  = .004), hypertension ( P  = .021), pupillary abnormality ( P  = .048), uncal herniation ( P  = .007), temporal lobe involvement ( P  = .016), additional infarction (MCA + anterior cerebral artery, posterior cerebral artery) ( P  = .001), and infarction growth rates ( P  = .025) were significantly higher in patients with unfavorable prognosis in univariate analysis. Multivariate analysis showed age, additional infarction, septum pellucidum deviation greater than 1 cm, and uncal herniation to be associated with a significantly poor prognosis. Time to surgery had no impact on outcome ( P  = .109). Conclusions Similar to the results of the studies from the West, DHC Improves functional outcome in predominantly South Asian patients with MMCA Stroke.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28579508</pmid><doi>10.1016/j.jstrokecerebrovasdis.2017.05.018</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0260-2086</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 1052-3057
ispartof Journal of stroke and cerebrovascular diseases, 2017-10, Vol.26 (10), p.2306-2312
issn 1052-3057
1532-8511
language eng
recordid cdi_proquest_miscellaneous_1906145755
source MEDLINE; ScienceDirect Journals (5 years ago - present)
subjects Cardiovascular
Comorbidity
Cross-Sectional Studies
Decompressive Craniectomy - methods
decompressive hemicraniectomy
Female
Humans
Infarction, Middle Cerebral Artery - mortality
Infarction, Middle Cerebral Artery - surgery
Logistic Models
Male
Malignant middle cerebral artery
Middle Aged
mRS
Multivariate Analysis
Neurology
Pakistan
prognosis and outcomes
Qatar
Retrospective Studies
Severity of Illness Index
Time-to-Treatment
Treatment Outcome
United Arab Emirates
title Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke: South Asian Experience
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T19%3A08%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Decompressive%20Hemicraniectomy%20for%20Malignant%20Middle%20Cerebral%20Artery%20Stroke:%20South%20Asian%20Experience&rft.jtitle=Journal%20of%20stroke%20and%20cerebrovascular%20diseases&rft.au=Kamran,%20Saadat,%20MD&rft.date=2017-10-01&rft.volume=26&rft.issue=10&rft.spage=2306&rft.epage=2312&rft.pages=2306-2312&rft.issn=1052-3057&rft.eissn=1532-8511&rft_id=info:doi/10.1016/j.jstrokecerebrovasdis.2017.05.018&rft_dat=%3Cproquest_cross%3E1906145755%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1906145755&rft_id=info:pmid/28579508&rft_els_id=1_s2_0_S1052305717302379&rfr_iscdi=true