{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T10:25:20Z","timestamp":1769941520935,"version":"3.49.0"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,10]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Decompressive surgery within 48 hours in patients younger than 60 years of age reduces mortality and morbidity from malignant supratentorial infarction. The goal of this study was to characterize the utilization of decompressive surgery in the Czech Republic in 2006.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This nationwide study was undertaken from September to December 2007 using a questionnaire sent to all neurosurgery departments in the Czech Republic. Diagnosis of brain infarction and decompressive surgery was based on discharge codes. Patient data were retrieved from hospital charts. Favorable outcome was defined as a modified Rankin scale score \u22644 on the day of discharge from the hospital.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Data were obtained from 15 of the 16 neurosurgery departments in the Czech Republic (94%) and from 39 patients (11 female [28%]). The average patient age was 52 \u00b1 14 years (11 patients &gt; 60), median time to surgery was 48 hours (interquartile range [IQR] 26\u201367 hours; 15 patients &gt; 48 hours), median National Institutes of Health Stroke Scale score was 22 (IQR 16\u201330), median infarct volume was 341 cm<jats:sup>3<\/jats:sup> (IQR 243\u2013375 cm<jats:sup>3<\/jats:sup>), mean shift from the midline was 9.9 \u00b1 4.1 mm, median duration of hospitalization was 19 days (IQR 13\u201330 days), and mean bone flap surface area was 75 cm<jats:sup>2<\/jats:sup> (IQR 70\u201397 cm<jats:sup>2<\/jats:sup>). A favorable outcome was achieved in 19 patients (49%). The median number of procedures per site in 2006 was 1.5 (range 0\u201313 procedures). Five sites (31%) serving one-third of the entire population did not perform any decompressive surgery. No variable was a significant predictor of outcome in a multiple regression model.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In 2006 decompressive surgery was underutilized and occurred late in the clinical course in the Czech Republic. Revision of national guidelines is necessary to incorporate the latest data and ensure that the patients who can benefit most receive treatment.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.10.jns09888","type":"journal-article","created":{"date-parts":[[2009,11,13]],"date-time":"2009-11-13T15:03:44Z","timestamp":1258124624000},"page":"897-900","source":"Crossref","is-referenced-by-count":5,"title":["Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors"],"prefix":"10.3171","volume":"113","author":[{"given":"Michal","family":"Bar","sequence":"first","affiliation":[{"name":"Neurology, Neurosurgery, and Radiology Department, Faculty Hospital, Ostrava;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Mikulik","sequence":"additional","affiliation":[{"name":"Neurology Department, Masaryk University, St. Anne Hospital, Brno;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"\u0160koloud\u00edk","sequence":"additional","affiliation":[{"name":"Neurology, Neurosurgery, and Radiology Department, Faculty Hospital, Ostrava;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Czerny","sequence":"additional","affiliation":[{"name":"Neurology, Neurosurgery, and Radiology Department, Faculty Hospital, Ostrava;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radim","family":"Lipina","sequence":"additional","affiliation":[{"name":"Neurology, Neurosurgery, and Radiology Department, Faculty Hospital, Ostrava;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Klecka","sequence":"additional","affiliation":[{"name":"Neurology Department, City Hospital, Ostrava;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vilem","family":"Juran","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Faculty Hospital, Brno-Bohunice;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Mra\u010dek","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Faculty Hospital, Pilsen;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denisa","family":"Vondr\u00e1\u010dkov\u00e1","sequence":"additional","affiliation":[{"name":"Neurology Department, Na Homolce Hospital, Prague;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lumir","family":"Hrabalek","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Faculty Hospital, Olomouc;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Brzezny","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Faculty Hospital, Motol, Prague; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Dienelt","sequence":"additional","affiliation":[{"name":"Neurology and Neurosurgery Department, Region Hospital, Liberec, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns09888","series-title":"J Neurol Neurosurg Psychiatry","first-page":"16","article-title":"A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project\u20141981-86. 2. Incidence, case fatality rates and overall outcome at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage","volume":"53","author":"Bamford","year":"1990"},{"key":"b2-jns09888","series-title":"Neurosurgery","first-page":"681","article-title":"Factors associated with outcome after hemicraniectomy for large middle cerebral artery territory infarction","volume":"56","author":"Curry","year":"2005"},{"key":"b3-jns09888","series-title":"Stroke","first-page":"539","article-title":"Hemicraniectomy for massive middle cerebral artery territory infarction: a systematic review","volume":"35","author":"Gupta","year":"2004"},{"key":"b4-jns09888","series-title":"Arch Neurol","first-page":"309","article-title":"\u2018Malignant\u2019 middle cerebral artery territory infarction: clinical course and prognostic signs","volume":"53","author":"Hacke","year":"1996"},{"key":"b5-jns09888","series-title":"Stroke","first-page":"2518","article-title":"Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery (DESTINY): a randomized, controlled trial","volume":"38","author":"J\u00fcttler","year":"2007"},{"key":"b6-jns09888","series-title":"Czech and Slovak Neurology and Neurosurgery","first-page":"4","article-title":"[The National Cerebrovascular Program.]","volume":"67\/100","year":"2004"},{"key":"b7-jns09888","series-title":"Neurosurg Clin N Am","first-page":"459","article-title":"Hemicraniectomy and durotomy for malignant middle cerebral artery infarction","volume":"19","author":"Schneck","year":"2008"},{"key":"b8-jns09888","series-title":"Stroke","first-page":"492","article-title":"Early mortality following stroke: a prospective review","volume":"15","author":"Silver","year":"1984"},{"key":"b9-jns09888","series-title":"Stroke","first-page":"491","article-title":"Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration for the International Stroke Incidence Collaboration: comparable studies of the incidence of stroke and its pathological types","volume":"28","author":"Sudlow","year":"1997"},{"key":"b10-jns09888","series-title":"Lancet Neurol","first-page":"215","article-title":"Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials","volume":"6","author":"Vahedi","year":"2007"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/4\/article-p897.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/4\/article-p897.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/4\/article-p897.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T04:40:46Z","timestamp":1679892046000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/4\/article-p897.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2010,10]]},"references-count":10,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2009.10.jns09888","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,10]]}}}