ABSTRACT NUMBER: ESOC2026A2424 EPIDEMIOLOGICAL PROFILE AND CLINICAL OUTCOMES FROM PATIENTS WHO UNDERWENT DESCOMPRESSIVE CRANIECTOMY FOR MALIGNANT MIDDLE CEREBRAL ARTERY STROKE IN A BRAZILIAN HOSPITAL

Abstract Background and aims Ischemic stroke remains a leading cause of mortality worldwide. Malignant Middle Cerebral Artery Infarction (MMCAI) is associated with high mortality rates under conservative medical management alone. In this context, decompressive craniectomy (DC) emerges as a life-saving intervention, despite the substantial morbidity observed among survivors. The aim of this study is to verify the epidemiological profile and the clinical outcomes from patients who underwent an DC at a Brazilian hospital. Methods A prospective stroke database was retrospectively evaluated, and all patients treated with decompressive craniectomy for MMCAI between August 2014 and September 2023 were included. The demographics and clinical characteristics were evaluated by using descriptive statistics. Results We included 55 patients on the final analysis. The mean age was 53,7± 12,57 years and 58,1% were males. The median NIHSS at admission was 18 (9-26). The left hemisphere was the affected in 45,4%.The mean time from symptoms to surgery was 36,9 ± 32,8 hours. 13 (23,6%) patients received intravenous thrombolysis and 9 (16,3%) underwent EVT (endovascular trombectomy).The average length of stay in hospital was 44,5 days. The most common complication was hospitalar-acquired pneumonia (63,6%). The in-hospital mortality was 34,5%. Conclusions Decompressive craniectomy continues to play a vital life-saving role in MMCAI, particularly within the practical and resource-limited context of middle-income countries. Conflict of interest NOTHING TO DISCLOSE