@misc{vassiliou_l.-v._impact_2016,
	title = {Impact of malignant cerebral artery infarction guidelines on the profile of the cranioplasty service},
	abstract = {Background: Early decompressive craniectomy (DC) for malignant middle cerebral artery (MCA) infarction leads to improved survival, as demonstrated by three multicenter randomized controlled trials (DECIMAL, DESTINY, HAMLET). The survivors of a malignant MCA stroke manifest complex medical and neurological problems along with extensive calvarial defects that require cranioplasty.Aims and methodology: This is a retrospective study from a tertiary referral center. We assess the impact of the new MCA stroke guidelines in the number of craniectomy patients referred for cranioplasty. We analyze the postoperative course of this specific subgroup of patients and we compare it against the contemporary cranioplasties population (craniectomy defects following traumatic brain injury, hemorrhagic strokes, oncological ablation, or infections).Results: Data of 78 patients (46 male, 32 female) referred for cranioplasty were analyzed over a 2-year period. Mean age was 42 years (range 12-73). In a representative year (2011), prior to the new stroke guidelines, only 4/30 (13\%) cases had DC for malignant MCA infarction, whereas subsequently in 2015, 15/48 (31\%) of the cranioplasty candidates had previously suffered malignant MCA infarction. Whilst the majority of patients were discharged on the third postoperative day and the overall complication rate was low (7\%), the postoperative course of post-malignant MCA patients was often complicated due to associated medical comorbidities leading to prolonged hospital stay.Conclusion: Reconstruction of the cranial vault in patients post-craniectomy for malignant MCA infarction poses complex perioperative challenges. The increasing demand for cranioplasty in this subset of patients necessitates appropriate neuro-intensive care infrastructure and expertise.},
	journal = {British Journal of Oral and Maxillofacial Surgery},
	author = {{Vassiliou L.-V.} and {Kim E.E.-Y.} and {Williams L.} and {Bentley R.P.}},
	year = {2016},
	keywords = {*cerebral artery disease, *consensus development, *cranioplasty, Child, adolescent, adult, aged, brain hemorrhage, cancer epidemiology, clinical trial, comorbidity, controlled clinical trial, controlled study, decompressive craniectomy, female, hospitalization, human, infection, intensive care, major clinical study, male, multicenter study, randomized controlled trial, retrospective study, surgery, survivor, tertiary care center, traumatic brain injury}
}

{"_id":"5HdyvZ5cS3shXKfkL","bibbaseid":"vassilioulv-kimeey-williamsl-bentleyrp-impactofmalignantcerebralarteryinfarctionguidelinesontheprofileofthecranioplastyservice-2016","downloads":0,"creationDate":"2017-05-12T20:20:57.548Z","title":"Impact of malignant cerebral artery infarction guidelines on the profile of the cranioplasty service","author_short":["Vassiliou L.-V.","Kim E.E.-Y.","Williams L.","Bentley R.P."],"year":2016,"bibtype":"misc","biburl":"http://bibbase.org/zotero/gxu917","bibdata":{"bibtype":"misc","type":"misc","title":"Impact of malignant cerebral artery infarction guidelines on the profile of the cranioplasty service","abstract":"Background: Early decompressive craniectomy (DC) for malignant middle cerebral artery (MCA) infarction leads to improved survival, as demonstrated by three multicenter randomized controlled trials (DECIMAL, DESTINY, HAMLET). The survivors of a malignant MCA stroke manifest complex medical and neurological problems along with extensive calvarial defects that require cranioplasty.Aims and methodology: This is a retrospective study from a tertiary referral center. We assess the impact of the new MCA stroke guidelines in the number of craniectomy patients referred for cranioplasty. We analyze the postoperative course of this specific subgroup of patients and we compare it against the contemporary cranioplasties population (craniectomy defects following traumatic brain injury, hemorrhagic strokes, oncological ablation, or infections).Results: Data of 78 patients (46 male, 32 female) referred for cranioplasty were analyzed over a 2-year period. Mean age was 42 years (range 12-73). In a representative year (2011), prior to the new stroke guidelines, only 4/30 (13%) cases had DC for malignant MCA infarction, whereas subsequently in 2015, 15/48 (31%) of the cranioplasty candidates had previously suffered malignant MCA infarction. Whilst the majority of patients were discharged on the third postoperative day and the overall complication rate was low (7%), the postoperative course of post-malignant MCA patients was often complicated due to associated medical comorbidities leading to prolonged hospital stay.Conclusion: Reconstruction of the cranial vault in patients post-craniectomy for malignant MCA infarction poses complex perioperative challenges. The increasing demand for cranioplasty in this subset of patients necessitates appropriate neuro-intensive care infrastructure and expertise.","journal":"British Journal of Oral and Maxillofacial Surgery","author":[{"firstnames":[],"propositions":[],"lastnames":["Vassiliou L.-V."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Kim E.E.-Y."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Williams L."],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Bentley R.P."],"suffixes":[]}],"year":"2016","keywords":"*cerebral artery disease, *consensus development, *cranioplasty, Child, adolescent, adult, aged, brain hemorrhage, cancer epidemiology, clinical trial, comorbidity, controlled clinical trial, controlled study, decompressive craniectomy, female, hospitalization, human, infection, intensive care, major clinical study, male, multicenter study, randomized controlled trial, retrospective study, surgery, survivor, tertiary care center, traumatic brain injury","bibtex":"@misc{vassiliou_l.-v._impact_2016,\n\ttitle = {Impact of malignant cerebral artery infarction guidelines on the profile of the cranioplasty service},\n\tabstract = {Background: Early decompressive craniectomy (DC) for malignant middle cerebral artery (MCA) infarction leads to improved survival, as demonstrated by three multicenter randomized controlled trials (DECIMAL, DESTINY, HAMLET). The survivors of a malignant MCA stroke manifest complex medical and neurological problems along with extensive calvarial defects that require cranioplasty.Aims and methodology: This is a retrospective study from a tertiary referral center. We assess the impact of the new MCA stroke guidelines in the number of craniectomy patients referred for cranioplasty. We analyze the postoperative course of this specific subgroup of patients and we compare it against the contemporary cranioplasties population (craniectomy defects following traumatic brain injury, hemorrhagic strokes, oncological ablation, or infections).Results: Data of 78 patients (46 male, 32 female) referred for cranioplasty were analyzed over a 2-year period. Mean age was 42 years (range 12-73). In a representative year (2011), prior to the new stroke guidelines, only 4/30 (13\\%) cases had DC for malignant MCA infarction, whereas subsequently in 2015, 15/48 (31\\%) of the cranioplasty candidates had previously suffered malignant MCA infarction. Whilst the majority of patients were discharged on the third postoperative day and the overall complication rate was low (7\\%), the postoperative course of post-malignant MCA patients was often complicated due to associated medical comorbidities leading to prolonged hospital stay.Conclusion: Reconstruction of the cranial vault in patients post-craniectomy for malignant MCA infarction poses complex perioperative challenges. The increasing demand for cranioplasty in this subset of patients necessitates appropriate neuro-intensive care infrastructure and expertise.},\n\tjournal = {British Journal of Oral and Maxillofacial Surgery},\n\tauthor = {{Vassiliou L.-V.} and {Kim E.E.-Y.} and {Williams L.} and {Bentley R.P.}},\n\tyear = {2016},\n\tkeywords = {*cerebral artery disease, *consensus development, *cranioplasty, Child, adolescent, adult, aged, brain hemorrhage, cancer epidemiology, clinical trial, comorbidity, controlled clinical trial, controlled study, decompressive craniectomy, female, hospitalization, human, infection, intensive care, major clinical study, male, multicenter study, randomized controlled trial, retrospective study, surgery, survivor, tertiary care center, traumatic brain injury}\n}\n\n","author_short":["Vassiliou L.-V.","Kim E.E.-Y.","Williams L.","Bentley R.P."],"key":"vassiliou_l.-v._impact_2016","id":"vassiliou_l.-v._impact_2016","bibbaseid":"vassilioulv-kimeey-williamsl-bentleyrp-impactofmalignantcerebralarteryinfarctionguidelinesontheprofileofthecranioplastyservice-2016","role":"author","urls":{},"keyword":["*cerebral artery disease","*consensus development","*cranioplasty","Child","adolescent","adult","aged","brain hemorrhage","cancer epidemiology","clinical trial","comorbidity","controlled clinical trial","controlled study","decompressive craniectomy","female","hospitalization","human","infection","intensive care","major clinical study","male","multicenter study","randomized controlled trial","retrospective study","surgery","survivor","tertiary care center","traumatic brain injury"],"downloads":0,"html":""},"search_terms":["impact","malignant","cerebral","artery","infarction","guidelines","profile","cranioplasty","service","vassiliou l.-v.","kim e.e.-y.","williams l.","bentley r.p."],"keywords":["*cerebral artery disease","*consensus development","*cranioplasty","child","adolescent","adult","aged","brain hemorrhage","cancer epidemiology","clinical trial","comorbidity","controlled clinical trial","controlled study","decompressive craniectomy","female","hospitalization","human","infection","intensive care","major clinical study","male","multicenter study","randomized controlled trial","retrospective study","surgery","survivor","tertiary care center","traumatic brain injury"],"authorIDs":[],"dataSources":["9LqPNaySNpNxYBFzj"]}