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22. European Stroke Conference 16:30-18:00 Oral Session Room 2,3,4 Meta-analysis and reviews Chairs: J. Stam, The Netherlands and C. Sudlow, UK 1 Meta-analysis and reviews 16:30 - 16:40 QUALITY OF LIFE, DEPRESSION AND CAREGIVER BURDEN AFTER HEMICRA-NIECTOMY FOR A MALIGNANT HEMISPHERIC INFARCT – a systematic review E. Richard1, T. van Middelaar2, H.B. van der Worp3, P.J. Nederkoorn4 Academic Medical Center, University of Amsterdam, Amsterdam, THE NETHER-LANDS1, Academic Medical Center, University of Amsterdam, Amsterdam, THE NETHER-LANDS2, University Medical Center Utrecht, Utrecht, THE NETHERLANDS3, Academic Medical Center, University of Amsterdam, Amsterdam, THE NETHERLANDS4 Background A large infarct in the territory of the middle cerebral artery can lead to life-threat-ening brain edema and herniation, often referred to as ‘malignant’ infarct. Hemicraniectomy can be a life-saving surgical procedure, but patients often survive with severe disability. The aim of this study was to systematically review the literature on quality of life (QoL), depres-sion and caregiver burden in patients who underwent a hemicraniectomy for a malignant in-farct. Methods We searched MEDLINE, EMBASE and PsycINFO (to June 2012). Randomized controlled trials, cohort studies, case-control studies and case-series were included if QoL, depression or caregiver burden were the primary or secondary outcome measure. Results Of 462 articles, 15 reporting on a total of 354 patients could be included in this review. Follow-up data were available for 265 patients, after periods of 6 to 51 months. Mortality at follow-up was 26%. Survival with good functional outcome was reported in 42% of the cases if defined as a score on the modified Rankin Scale ≤3. Mean QoL varied from 44-64%, based on question-naires and ‘Visual Analogue Scales’ (n= 8 studies). In eight studies, 70-100% of the patients were satisfied with the treatment received. Lower percentages were found in two studies with an older patient population (50%, 65%). QoL and treatment satisfaction were comparable be-tween patients with an infarct in the dominant and non-dominant hemisphere. Severe depres-sive symptoms were documented in 17% of the patients. One study assessed caregiver burden, but findings were inconclusive. Conclusion The majority of patients with a malignant infarct appear to have an acceptable quality of life after hemicraniectomy, in spite of moderate to se-vere handicap. This is confirmed by the fact that most patients were satisfied with the treatment. Severe depressive symptoms in these patients are rare. Caregiver burden has not been assessed sufficiently. 16:30-18:00 Rooms 14,15,16 Mini Symposium 5 Clinical relevance of stroke genetics Clinical relevance of stroke genetics Chairs: H. Markus, UK and A. Algra, The Netherlands Conventional risk factors for stroke; what we know and what we do not know. A. Algra, The Netherlands New genes for stroke; what do they tell us about stroke mechanisms? H. Markus, UK Using genetics to determine the role of conventional risk factors? A. Hingorani, UK What is the future for personalised genetic medicine? M. Dichgans, Germany 156 © 2013 S. Karger AG, Basel Scientific Programme


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