Long-term health-related quality of life after decompressive hemicraniectomy in stroke patients with life-threatening space-occupying brain edema

Research output: Journal contributionsJournal articlesResearch


  • B. Von Sarnowski
  • W. Kleist-Welch Guerra
  • T. Kohlmann
  • J. Moock
  • A.V. Khaw
  • C. Kessler
  • U. Schminke
  • H.W.S. Schroeder

Background: Although randomized clinical trials have reported significant improvement in mortality and functional outcome as measured with modified Rankin Scale (mRS) or Barthel index (BI) in stroke patients with space-occupying anterior circulation infarctions treated with hemicraniectomy, many clinicians are still concerned about the long-term health-related quality of life (HRQoL). Aim: Assessment of HRQoL after hemicraniectomy to holistically reevaluate clinical outcome. Methods: Eleven patients (6 men, 5 women; mean age 48 (SD 5.8) years) were examined at 9-51 months after hemicraniectomy. Test batteries comprised NIH stroke scale, BI, mRS, neuropsychological tests (Visual Object and Space Perception Battery and clock test), and HRQoL-scales (Short Form 36 Health Survey (SF-36), Nottingham Health Profile (NHP), Questions on Life Satisfaction, Hospital Anxiety and Depression Scale and EQ-5D). Results: Median values for NIHSS, BI and mRS were 11.5, 55 and 3.5. In HRQoL-scales, subscales related to physical mobility and functioning were consistently severely impaired, while subscales related to psychological well-being were impaired to a lesser extent. Mean scores for physical functioning and physical role were 10.5 and 12.5 in the SF-36, and 61.3 and 43.3 for physical mobility and energy in the NHP; emotional role and mental health scored 63.3 and 66.4 (SF-36), scores for emotional reaction and social isolation were 18.9 and 16.0 (NHP), respectively. Conclusion: Although, physical components of HRQoL are highly impaired, these stroke patients achieved a satisfying level of psychological well-being which was endorsed by a nearly unanimous retrospective appraisal of life-saving hemicraniectomy.

Original languageEnglish
JournalClinical Neurology and Neurosurgery
Issue number6
Pages (from-to)627-633
Number of pages7
Publication statusPublished - 01.07.2012

    Research areas

  • Health sciences - Acute stroke treatment, Decompressive surgery, Health-related quality of life, Stroke outcome