Surgical treatment for acute, severe XXXX .

@entity1 @entity4798 @entity6220 @entity64 @entity6 @entity2500 @entity4 @entity16 @entity772 @entity1188 @entity204 @entity385
OBJECTIVE: @entity64 is the most prevalent @entity6220 . Since medical modalities are sometimes ineffective for the acute @entity4 following massive @entity1188 may be an effective option when medical treatments fail. The present study was undertaken to assess the outcome and prognostic factors of decompressive surgery in life threatening acute, severe, @entity4798 . METHODS: We retrospectively analyzed twenty-six @entity1 (17 males and 9 females; average age, 49.7yrs) who underwent decompressive surgery for severe @entity385 from January 2003 to December 2006. Surgical indication was based on the clinical signs such as @entity16 , pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). RESULTS: Of the 26 @entity1 , 5 (19.2%) showed good recovery, 5 (19.2%) showed moderate disability, 2 (7.7%) severe disability, 6 (23.1%) persistent experienced vegetative state, and 8 (30.8%) @entity204 . In this study, the surgical decompression improved outcome for @entity1188 , but decompressive surgery did not show a good result for @entity2500 (30.8% overall mortality vs 100% mortality). The dominant-hemisphere @entity1188 showed worse prognosis, compared with nondominant-hemisphere @entity1188 (54.5% vs 70%). Poor prognostic factors were @entity6 , dominant-hemisphere @entity1188 and low preoperative Glasgow @entity772 Scale (GCS) score. CONCLUSION: The @entity1 who exhibit clinical deterioration despite aggressive medical management following severe @entity385 should be considered for decompressive surgery. For better outcome, prompt surgical treatment is mandatory. We recommend that @entity1 with severe @entity385 should be referred to neurosurgical department primarily in emergency setting or as early as possible for such prompt surgical treatment.
