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Surgery after major stroke also improves survival odds in elderly patients
Date:3/20/2014

Patients who are over the age of 60 and have suffered a major stroke due to blockage of the middle cerebral artery benefit from hemicraniectomy removal of part of the skull located above the affected brain tissue. The procedure relieves increased pressure on the brain in the first 48 hours after the stroke. These patients' chances of survival increase two-fold if they undergo surgery. However, patients who have been operated on often survive with severe disabilities, while patients who do not undergo the surgery generally die quickly. These findings were obtained in a study conducted by 13 German stroke centers led by Heidelberg University Hospital's Departments of Neurology and Neurosurgery and have been published in the current issue of the renowned New England Journal of Medicine.

"For the first time, it has now been proven that for a cohort of elderly patients too, hemicraniectomy can save lives," explained Professor Werner Hacke, Medical Director of Heidelberg University Hospital's Department of Neurology. A study published 5 years ago showed that in patients below the age of 60, the results of the procedure are more favorable (see Lancet Neurology, 2007 under Literature). "In younger patients, the surgery tripled the chances of survival. In addition, they rarely sustained severe disabilities," said Professor Andreas Unterberg, Medical Director at Heidelberg University Hospital's Department of Neurosurgery. "We were not surprised by the lower treatment effect in the current study, since we know that the older a stroke patient, the poorer his or her prognosis."

Elderly patients: Overall poorer prognosis after severe stroke

The prognosis in patients with a blockage of the middle cerebral artery is very poor. In nearly 80% of the patients, without surgery, it causes death in a matter of days, even if they receive the maximum possible conservative intensive care. The necrotic brain tissue and its surroundings expand
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Contact: Professor Werner Hacke
werner.hacke@med.uni-heidelberg.de
49-062-215-68210
Heidelberg University Hospital
Source:Eurekalert  

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Surgery after major stroke also improves survival odds in elderly patients
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