Preliminary results of randomized controlled study on decompressive craniectomy in treatment of malignant middle cerebral artery stroke.

Background And Objective: Studies on decompressive craniectomy (DCE) after a malignant middle cerebral artery (MCA) stroke in selected population show an increased probability of survival without increasing the number of very severely disabled. Cerebral infarct volume (CIV) as a triage criterion for performing surgery has not been discussed in literature. The aim of this study was to investigate the value of CIV and initial National Institutes of Health Stroke Scale (NIHHS) and Glasgow Coma Scale (GCS) scores as possible triage criteria in the surgical treatment of patients with "malignant" MCA stroke.

Association between implementation of clinical practice guidelines and outcome for traumatic brain injury.

Background: Traumatic brain injury (TBI) is the leading cause of death in the population under 40 years of age in Western countries, and the same was true for Latvia in 1999. This indicated a strong need to improve the management of TBI. The Latvian Society of Neurosurgeons in collaboration with related societies created a dedicated working group, and the Guidelines for Medical Management of TBI in Latvia (Guidelines) were developed in 2001.