caa a22 4500 445808039 CHVBK 20180317145202.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00415-011-6003-3 doi (NATIONALLICENCE)springer-10.1007/s00415-011-6003-3 Decompressive surgery for malignant supratentorial infarction remains underutilized after guideline publication [Elektronische Daten] [Michal Bar, Robert Mikulik, David Skoloudik, Daniel Czerny, Radim Lipina, Martin Sames, Milan Choc, Zdenek Novak, Marian Stary, Vladimir Benes, Martin Smrcka, Michal Filip, Denisa Vondrackova, Vladimir Chlouba, Petr Suchomel, Pavel Haninec, Richard Brzezny, Vilem Juran] Decompressive surgery <48h from stroke onset reduces the prevalence of mortality and morbidity from malignant supratentorial infarction. We investigated if utilization of decompressive surgery changed in the Czech Republic (CZ) after the release of new guidelines regarding treatment of malignant brain infarction. The volume of decompressive surgery in 2009 in all centers in the CZ was assessed using the same methodology as in 2006. All neurosurgery departments in the CZ were asked to complete a questionnaire and asked to identify all cases of decompressive surgery for malignant brain infarction through a combination of discharge codes for "brain infarction” and "decompressive surgery” from electronic hospital charts. Data for 56 patients were obtained from 15 of the 16 neurosurgery departments in the CZ. The average age was 53±13; number of males 20; median time to surgery was 48h (range 24-62); median NIHSS score was 25 (IQR, 20-30); median infarct volume was 300cm3 [interquartile (IQR, 250-350)]; mean shift on CT was 10.6±3.6mm and size of hemicraniectomy was 125cm2 (IQR, 110-154). A favorable outcome was achieved in 45% of the patients. The number of procedures increased from 39 in 2,006 to 2,056 in 2009. Based on data from one stroke center, 10% suffered from malignant supratentorial infarction and 2.3% met the criteria for decompressive surgery. In 2009, as compared to 2006, the volume of decompressive surgery carried out moderately increased. However, procedures remained underutilized because only ~10% of those who needed decompressive surgery underwent surgery. Springer-Verlag, 2011 Malignant ischemic stroke nationallicence Decompressive surgery nationallicence Guideline nationallicence Utilization nationallicence Eligible criteria nationallicence Prevalence nationallicence Bar Michal Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut Mikulik Robert Department of Neurology, International Clinical Research Center and Department of Neurosurgery, St. Anne Hospital, Brno, Czech Republic aut Skoloudik David Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut Czerny Daniel Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut Lipina Radim Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut Sames Martin Department of Neurosurgery, Masaryk Hospital, Usti nad Labem, Czech Republic aut Choc Milan Department of Neurosurgery, Faculty Hospital, Pilsen, Czech Republic aut Novak Zdenek Department of Neurology, International Clinical Research Center and Department of Neurosurgery, St. Anne Hospital, Brno, Czech Republic aut Stary Marian Department of Neurosurgery, City Hospital, Ostrava, Czech Republic aut Benes Vladimir Department of Neurosurgery, Military Hospital Prague, Prague, Czech Republic aut Smrcka Martin Department of Neurosurgery, Faculty Hospital, Brno, Czech Republic aut Filip Michal Department of Neurosurgery, Bata Hospital, Zlin, Czech Republic aut Vondrackova Denisa Department of Neurology, Na Homolce Hospital, Prague, Czech Republic aut Chlouba Vladimir Department of Neurosurgery, Regional Hospital, Ceske Budejovice, Czech Republic aut Suchomel Petr Department of Neurosurgery, Regional Hospital, Liberec, Czech Republic aut Haninec Pavel Department of Neurosurgery, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic aut Brzezny Richard Department of Neurosurgery, Faculty Hospital, Motol, Prague, Czech Republic aut Juran Vilem Department of Neurosurgery, Faculty Hospital, Brno, Czech Republic aut Journal of Neurology Springer-Verlag 258/9(2011-09-01), 1689-1694 0340-5354 258:9<1689 2011 258 415 https://doi.org/10.1007/s00415-011-6003-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-6003-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bar Michal Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut NATIONALLICENCE 700 1- Mikulik Robert Department of Neurology, International Clinical Research Center and Department of Neurosurgery, St. Anne Hospital, Brno, Czech Republic aut NATIONALLICENCE 700 1- Skoloudik David Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut NATIONALLICENCE 700 1- Czerny Daniel Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut NATIONALLICENCE 700 1- Lipina Radim Department of Neurology, Department of Neurosurgery and Department of Radiology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52, Ostrava, Czech Republic aut NATIONALLICENCE 700 1- Sames Martin Department of Neurosurgery, Masaryk Hospital, Usti nad Labem, Czech Republic aut NATIONALLICENCE 700 1- Choc Milan Department of Neurosurgery, Faculty Hospital, Pilsen, Czech Republic aut NATIONALLICENCE 700 1- Novak Zdenek Department of Neurology, International Clinical Research Center and Department of Neurosurgery, St. Anne Hospital, Brno, Czech Republic aut NATIONALLICENCE 700 1- Stary Marian Department of Neurosurgery, City Hospital, Ostrava, Czech Republic aut NATIONALLICENCE 700 1- Benes Vladimir Department of Neurosurgery, Military Hospital Prague, Prague, Czech Republic aut NATIONALLICENCE 700 1- Smrcka Martin Department of Neurosurgery, Faculty Hospital, Brno, Czech Republic aut NATIONALLICENCE 700 1- Filip Michal Department of Neurosurgery, Bata Hospital, Zlin, Czech Republic aut NATIONALLICENCE 700 1- Vondrackova Denisa Department of Neurology, Na Homolce Hospital, Prague, Czech Republic aut NATIONALLICENCE 700 1- Chlouba Vladimir Department of Neurosurgery, Regional Hospital, Ceske Budejovice, Czech Republic aut NATIONALLICENCE 700 1- Suchomel Petr Department of Neurosurgery, Regional Hospital, Liberec, Czech Republic aut NATIONALLICENCE 700 1- Haninec Pavel Department of Neurosurgery, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic aut NATIONALLICENCE 700 1- Brzezny Richard Department of Neurosurgery, Faculty Hospital, Motol, Prague, Czech Republic aut NATIONALLICENCE 700 1- Juran Vilem Department of Neurosurgery, Faculty Hospital, Brno, Czech Republic aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/9(2011-09-01), 1689-1694 0340-5354 258:9<1689 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer