r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2026-31-1-47-54r-n-j-808Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSЦелесообразность инфарктэктомии при злокачественном ишемическом инсульте в бассейне средней мозговой артерииFeasibility of infarctectomy in cases of malignant cerebral infarction in the middle cerebral artery territoryhttps://orcid.org/0000-0003-3942-7442Салах СехвейлМ. М.Salah SehweilM. M.

Ростов-на-Дону.

Rostov-on-Don.

salahsehweil@yandex.ruhttps://orcid.org/0000-0001-7580-0385СуфиановА. А.SufianovA. A.

Тюмень.

Tyumen.

sufianov@gmail.comhttps://orcid.org/0000-0001-7093-9548ГончароваЗ. А.GoncharovaZ. A.

Ростов-на-Дону.

Rostov-on-Don.

centrms@mail.ruhttps://orcid.org/0000-0003-4703-1616КириченкоЕ. Ю.KirichenkoE. Yu.

Ростов-на-Дону.

Rostov-on-Don.

kiriche.evgeniya@yandex.ruhttps://orcid.org/0000-0002-8873-3625ЛогвиновА. К.LogvinovA. K.

Лаборатория молекулярной нейробиологии

Ростов-на-Дону.

Rostov-on-Don.

filsv@yandex.ruhttps://orcid.org/0000-0003-4541-6707ДерибасВ. Ю.DeribasV. Yu.

Ростов-на-Дону.

Rostov-on-Don.

deribasv@yandex.ruРостовский государственный медицинский университетРоссияRostov State Medical UniversityRussian FederationФедеральный центр нейрохирургии Минздрава РФРоссияFederal Centre of NeurosurgeryRussian FederationДонской государственный технический университетРоссияDon State Technical UniversityRussian FederationАкадемия биологии и биотехнологии им. Д.И. Ивановского Южного федерального университетаРоссияSouthern Federal UniversityRussian Federation2026270420263114754Copyright © Салах Сехвейл М.М., Суфианов А.А., Гончарова З.А., Кириченко Е.Ю., Логвинов А.К., Дерибас В.Ю., 20262026Салах Сехвейл М.М., Суфианов А.А., Гончарова З.А., Кириченко Е.Ю., Логвинов А.К., Дерибас В.Ю.Salah Sehweil M.M., Sufianov A.A., Goncharova Z.A., Kirichenko E.Y., Logvinov A.K., Deribas V.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/808Введение

Введение. Злокачественный ишемический инсульт (ЗИИ) в бассейне средней мозговой артерии (СМА) характеризуется неизбежным развитием отека полушария головного мозга, результатом которого в конечном итоге является развитие височно-тенториального вклинения. Декомпрессивная гемикраниэктомия (ДГК) является операцией выбора при ЗИИ, однако, не предотвращает закономерного и стремительно прогрессирующего нарастания отека полушария головного мозга в послеоперационном периоде с последующим развитием внутричерепной гипертензии. В связи с этим, рядом авторов предлагается дополнение ДГК инфарктэктомией для улучшения результатов оперативного лечения. Вместе с тем, некоторые исследователи считают выполнение инфарктэктомии нецелесообразным.

Цель исследования

Цель исследования: определить целесообразность инфарктэктомии у пациентов со злокачественным ишемическим инсультом в бассейне средней мозговой артерии.

Материал и методы

Материал и методы. Девять пациентов в возрасте 47–68 лет (58,2 ± 2,2 годп) подверглись ДГК с дополнительным выполнением инфарктэктомии и тенториотомии. Всем пациентам выполняли морфологическое исследование биопсийного материала передней части височной доли.

Результаты

Результаты. Морфологические исследования резецированной передней части височной доли подтвердили наличие необратимых изменений мозговой ткани у всех пациентов. Результаты компьютерной томографии головного мозга, выполненной в динамике, выявили признаки порэнцефалических изменений и резорбции некротизированной мозговой ткани полушария головного мозга с замещением ее ликвором.

Заключение

Заключение. Необратимые морфологические изменения резецированной мозговой ткани и данные компьютерной томографии в динамике подтверждают целесообразность инфарктэктомии при злокачественном ишемическом инсульте в бассейне средней мозговой артерии.

Introduction

Introduction. Malignant middle cerebral artery (MCA) infarction is associated with the inevitable growth of cerebral hemisphere edema ultimately resulting in temporal transtentorial herniation. Decompressive hemicraniectomy (DCH) is the operation of choice for Malignant MCA; however, it does not prevent the predictable and rapidly progressive increase in cerebral hemisphere edema during the postoperative period, followed by the development of intracranial hypertension. Therefore, several authors suggest supplementing DHC with infarctectomy to improve surgical outcomes. At the same time, some researchers consider infarctectomy pointless.

Objective

Objective: to determine the feasibility of infarctectomy in patients with malignant MCA.

Material and methods

Material and methods. 9 patients aged 47–68 years (mean 58.2 ± 2.2 years) underwent DHC with additional infarctectomy and tentoriotomy. Morphological examination of biopsy materials from the anterior part of the temporal lobe was performed for all patients.

Results

Results. Morphological examination of the resected anterior part of the temporal lobe confirmed the presence of irreversible changes in the brain tissue in all patients. The results of follow-up computed tomography of the brain revealed porencephalic and signs of resorption of necrotized brain tissue of the cerebral hemisphere with its replacement by cerebrospinal fluid.

Conclusion

Conclusion. Irreversible morphological changes in the resected brain tissue and follow-up computed tomography data confirm the feasibility of infarctectomy in cases of malignant cerebral infarction in the territory supplied by the middle cerebral artery.

средняя мозговая артерияотек головного мозгазлокачественный ишемический инсультинфарктэктомиявнутричерепная гипертензияконнексин-43medial cerebral arterycerebral edemamalignant cerebral infarctioninfarctectomyintracranial hypertensionConnexin-43ReferencesLu W, Wu N, Qin Y, Li H. Endovascular thrombectomy combined with decompressive craniectomy for malignant anterior circulation large vessel occlusion stroke: a real-world study. World neurosurgery. 2025;202:1–8. https://doi.org/10/1016/j.wneu.2025.124394Lu W, Wu N, Qin Y, Li H. Endovascular thrombectomy combined with decompressive craniectomy for malignant anterior circulation large vessel occlusion stroke: a real-world study. World neurosurgery. 2025;202:1–8. https://doi.org/10/1016/j.wneu.2025.124394Das S, Mitchell P, Ross N, Whitfi eld PC. Decompressive hemicraniectomy in the treatment of malignant middle cerebral artery infarction: A meta-analysis. World neurosurgery. 2019;123:8–16. https://doi.org/10.1016/j.wneu.2018.11.176Das S, Mitchell P, Ross N, Whitfi eld PC. Decompressive hemicraniectomy in the treatment of malignant middle cerebral artery infarction: A meta-analysis. World neurosurgery. 2019;123:8–16. https://doi.org/10.1016/j.wneu.2018.11.176Pilato F, Pellegrino G, Calandrelli R, Broccolini A, Marca GD, Frisullo G, Morosetti R, Profi ce P, Brunetti V, Capone F, D’Apolito G, Quinci V, Albanese A, Mangiola A, Marchese E, Pompucci A, Di Lazzaro V. Decompressive hemicraniectomy in patients with malignant middle cerebral artery infarction: a real-world study. J Neurol Sci. 2022;441:120376. https://doi.org/10.1016/j.jns.2022.120376 PMID: 35952455.Pilato F, Pellegrino G, Calandrelli R, Broccolini A, Marca GD, Frisullo G, Morosetti R, Profi ce P, Brunetti V, Capone F, D’Apolito G, Quinci V, Albanese A, Mangiola A, Marchese E, Pompucci A, Di Lazzaro V. Decompressive hemicraniectomy in patients with malignant middle cerebral artery infarction: a real-world study. J Neurol Sci. 2022;441:120376. https://doi.org/10.1016/j.jns.2022.120376 PMID: 35952455.Pallesen L.-P, Barlinn K, Puetz V. Role of decompressive carniectomy in ischemic stroke. Front Neurol. 2019;9:1119. https://doi.org/10.3389/fneur.2018.01119 PMID: 30687210; PMCID: PMC6333741.Pallesen L.-P, Barlinn K, Puetz V. Role of decompressive carniectomy in ischemic stroke. Front Neurol. 2019;9:1119. https://doi.org/10.3389/fneur.2018.01119 PMID: 30687210; PMCID: PMC6333741.Zhao X, Feng D, Huang J, Zhang Y, Dunn I. Novel retro-auricular myocutaneous hemicraniectomy fl ap: technical note and cadaveric dissection World neurosurgery. 2023;19:100174. https://doi.org/10.1016/j.wnsx.2023.100174Zhao X, Feng D, Huang J, Zhang Y, Dunn I. Novel retro-auricular myocutaneous hemicraniectomy fl ap: technical note and cadaveric dissection World neurosurgery. 2023;19:100174. https://doi.org/10.1016/j.wnsx.2023.100174Berger N, Brunner A, Wunsch G, Nistl O, Pinter D, Fandler-Hofl er S, Haidegger M, Pichler A, Hatab I, Mokry M, Wolfsberger S, Enzinger C, Gattringer T, Kneihsl M. Long-term outcome after decompressive hemicraniectomy for malignant middle cerebral artery infarction. J Neurol. 2023;270:3475–3482. https://doi.org/10.1007/s00415-023-11679-1Berger N, Brunner A, Wunsch G, Nistl O, Pinter D, Fandler-Hofl er S, Haidegger M, Pichler A, Hatab I, Mokry M, Wolfsberger S, Enzinger C, Gattringer T, Kneihsl M. Long-term outcome after decompressive hemicraniectomy for malignant middle cerebral artery infarction. J Neurol. 2023;270:3475–3482. https://doi.org/10.1007/s00415-023-11679-1Rodrigues TP, Rodrigues MS, Bocca LF, Chaddad-Neto FE, Cavalheiro S, Junior EA, Silva GS, Suriano IC, Centeno RS. Decompressive craniectomy index: does the size of decompressive craniectomy matter in malignant middle cerebral artery infarction? Surg Neurol Int. 2022;13:580. https://doi.org//10.25259/SNI_895_2022 PMCID: PMC9805638. PMID: 36600778.Rodrigues TP, Rodrigues MS, Bocca LF, Chaddad-Neto FE, Cavalheiro S, Junior EA, Silva GS, Suriano IC, Centeno RS. Decompressive craniectomy index: does the size of decompressive craniectomy matter in malignant middle cerebral artery infarction? Surg Neurol Int. 2022;13:580. https://doi.org//10.25259/SNI_895_2022 PMCID: PMC9805638. PMID: 36600778.Funchal BF, Alves MM, Suriano IC, Chaddad-Neto FE, Ferraz M EMR, Silva GS. Intracranial pressure following decompressive hemicraniectomy for malignant cerebral infarction: clinical and treatment correlations. Arq neurosiquiatr. 2018;76(12):812–815. https://doi.org/10.1590/0004-282X20180132Funchal BF, Alves MM, Suriano IC, Chaddad-Neto FE, Ferraz M EMR, Silva GS. Intracranial pressure following decompressive hemicraniectomy for malignant cerebral infarction: clinical and treatment correlations. Arq neurosiquiatr. 2018;76(12):812–815. https://doi.org/10.1590/0004-282X20180132Berra LV, Rubiano A, Cedrone G, Capobianco M, Bassani A, Santoro A. Comparison of brain volume increase in patients with intracranial hypertension after decompressive craniectomy and expansion craniotomy. Neurosurg Rev. 2025;48:311. https://doi.org/10/1007/s10143-025-03440-1Berra LV, Rubiano A, Cedrone G, Capobianco M, Bassani A, Santoro A. Comparison of brain volume increase in patients with intracranial hypertension after decompressive craniectomy and expansion craniotomy. Neurosurg Rev. 2025;48:311. https://doi.org/10/1007/s10143-025-03440-1Paldor I, Rosenthal G, Cohen JE, Leker R, Harnof S, Shoshan Y, Itshayek E. Intracranial pressure monitoring following decompressive hemicraniectomy for malignant cerebral infarction. Clin Neurosci. 2015;22(1):79–82. https://doi.org/10.1016/j.jocn.2014.07.006Paldor I, Rosenthal G, Cohen JE, Leker R, Harnof S, Shoshan Y, Itshayek E. Intracranial pressure monitoring following decompressive hemicraniectomy for malignant cerebral infarction. Clin Neurosci. 2015;22(1):79–82. https://doi.org/10.1016/j.jocn.2014.07.006Vital R, Hamamoto Filho PT, Braga GP, Ducati LG, Luvizutto GJ, Gabarra RC, Schelp AO, Resende LAL, Zanini MA, Bazan R. WSC-0986. Acute stroke management. Decompressive hemicraniectomy in a South American population: morbitites and outcome analysis focusing on age differences. Int J Stroke. 2014;9(Sup.3):101. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijs.12367Vital R, Hamamoto Filho PT, Braga GP, Ducati LG, Luvizutto GJ, Gabarra RC, Schelp AO, Resende LAL, Zanini MA, Bazan R. WSC-0986. Acute stroke management. Decompressive hemicraniectomy in a South American population: morbitites and outcome analysis focusing on age differences. Int J Stroke. 2014;9(Sup.3):101. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijs.12367Slezins J, Keris V, Bricis R, Bricis R, Millers A, Valeinis E, Stukens J, Minibajeva O. Preliminary results of randomized controlled study on decompressive carniectomy in treatment of malignant middle cerebral artery stroke. Medicina (Kaunas). 2012;48(10):521–524. PMID: 23324248.Slezins J, Keris V, Bricis R, Bricis R, Millers A, Valeinis E, Stukens J, Minibajeva O. Preliminary results of randomized controlled study on decompressive carniectomy in treatment of malignant middle cerebral artery stroke. Medicina (Kaunas). 2012;48(10):521–524. PMID: 23324248.Lu W, Jia D, Qin Y. Decompressive craniectomy combined with temporal pole resection in the treatment of massive cerebral infarction. BMC Neurol. 2022;22(1):167. https://doi.org/10.1186/s12883-022-02688-0 PMID: 35501820. PMCID: PMC9063210.Lu W, Jia D, Qin Y. Decompressive craniectomy combined with temporal pole resection in the treatment of massive cerebral infarction. BMC Neurol. 2022;22(1):167. https://doi.org/10.1186/s12883-022-02688-0 PMID: 35501820. PMCID: PMC9063210.Tartara F, Colombo EV, Bongetta D, Pilloni G, Bortolotti C, Boeris C, Zenga F, Giossi A, Ciccone A, Sessa M, Cenzato M. Strokectomy and extensive cisternal CSF drain for acute management of malignant middle cerebral artery infarction: technical note and case series. Front Neurol. 2019;10:1017. https://doi.org/10.3389/fneur.2019.01017 PMID: 31616366. PMCID: PMC6775199.Tartara F, Colombo EV, Bongetta D, Pilloni G, Bortolotti C, Boeris C, Zenga F, Giossi A, Ciccone A, Sessa M, Cenzato M. Strokectomy and extensive cisternal CSF drain for acute management of malignant middle cerebral artery infarction: technical note and case series. Front Neurol. 2019;10:1017. https://doi.org/10.3389/fneur.2019.01017 PMID: 31616366. PMCID: PMC6775199.Moughl S, Trippier S, Al-Mousa A, Hainsworth AH, Pereira AC, Minhas PS, Shtaya A. Strokectomy for malignant middle cerebral artery infarction: experience and meta-analysis of current evidence. J Neurol. 2022;269(1):149–158. https://doi.org/10.1007/s00415-020-10358-9 PMID: 33340332. PMCID: PMC8739160.Moughl S, Trippier S, Al-Mousa A, Hainsworth AH, Pereira AC, Minhas PS, Shtaya A. Strokectomy for malignant middle cerebral artery infarction: experience and meta-analysis of current evidence. J Neurol. 2022;269(1):149–158. https://doi.org/10.1007/s00415-020-10358-9 PMID: 33340332. PMCID: PMC8739160.Першин МЕ, Еналдиев ГК, Шагал ЛВ, Тимченко ЛВ, Музлаев ГГ, Ткачев ВВ. Случай этапного лечения пациента со злокачественным ишемическим инфарктом мозга. Вопросы нейрохирургии имени Н.Н. Бурденко. 2023;87(5):85-93. https://doi.org/10.17116/neiro20238705185Pershin ME, Yenaldiev GK, Shagal LV, Timchenko LV, Muzlaev GG, Tkachev VV. Staged treatment of a patient with malignant ischemic cerebral infarction. Burdenko’s Journal of Neurosurgery (Voprosy Neirokhirurgii imeni N.N. Burdenko). 2023;87(5):85–93 (Russian). https://doi.org/10.17116/neiro20238705185 PMID: 37830473.Olivares KL, Sherma A, To CY, Muzammil SM. Managing malignant middle cerebral artery infarction with open scalp incision and partial hemispherectomy: illustrative case. J Neurosurg Case Lessons. 2025;10(11):CASE2523. https://doi.org/10.3171/CASE2523Olivares KL, Sherma A, To CY, Muzammil SM. Managing malignant middle cerebral artery infarction with open scalp incision and partial hemispherectomy: illustrative case. J Neurosurg Case Lessons. 2025;10(11):CASE2523. https://doi.org/10.3171/CASE2523Li N, He C, Li W, Zhang L, Li Y, Feng Y, Ding W, Guan M, Wang X, Wang S. The effi cacy of strokectomy in the treatment of malignant cerebral infarction patients. Research Square. 2021:1–14. https://doi.org/10.21203/rs.3.rs-151694/v1Li N, He C, Li W, Zhang L, Li Y, Feng Y, Ding W, Guan M, Wang X, Wang S. The effi cacy of strokectomy in the treatment of malignant cerebral infarction patients. Research Square. 2021:1–14. https://doi.org/10.21203/rs.3.rs-151694/v1Kwak Y, Kim B, Park J. Maximum decompressive hemicraniectomy for patients with malignant hemispheric infarction. J Cerebrovasc Endovasc Neurosurg. 2019;21(3):138–143. https://doi.org/10.7461/jcen.2019.21.3.138Kwak Y, Kim B, Park J. Maximum decompressive hemicraniectomy for patients with malignant hemispheric infarction. J Cerebrovasc Endovasc Neurosurg. 2019;21(3):138–143. https://doi.org/10.7461/jcen.2019.21.3.138Xie S, Ding J, Yao Y, Huang X, Chen Y, Xiong Y, Zhang T, Liu Y, Wang L. Craniectomy combined with rapid internal decompression in massive cerebral infarction: surgical technique and outcomes. J Korean Neurosurg Soc. 2025;68(4):405–414. https://doi.org/10.3340/jkns.2024.0210Xie S, Ding J, Yao Y, Huang X, Chen Y, Xiong Y, Zhang T, Liu Y, Wang L. Craniectomy combined with rapid internal decompression in massive cerebral infarction: surgical technique and outcomes. J Korean Neurosurg Soc. 2025;68(4):405–414. https://doi.org/10.3340/jkns.2024.0210Beucler N, Dagain A. Decompressive craniectomy: keep is simple! Acta Neurochirurgica. 2022;165(4):2377–2379. https://doi.org/10.1007/s00701-022-05280-0Beucler N, Dagain A. Decompressive craniectomy: keep is simple! Acta Neurochirurgica. 2022;165(4):2377–2379. https://doi.org/10.1007/s00701-022-05280-0Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL. Classifi cation of subtype of acute ischemic stoke. Defi nitions for use in multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):35–41. https://doi.org/10.1161/01.str.24.1.35 PMID: 7678184.Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL. Classifi cation of subtype of acute ischemic stoke. Defi nitions for use in multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):35–41. https://doi.org/10.1161/01.str.24.1.35 PMID: 7678184.Spilker J, Kongable G, Barch C, Braimah J, Brattina P, Daley S, Donnarumma R, Rapp K, Sailor S. Using the NIH Stroke Scale to assess stroke patients. The NINDS rt-PA Stroke Study Group. J Neurosci Nurs. 1997;29(6):384–392. https://doi.org/10.1097/01376517-199712000-00008 PMID: 9479660.Spilker J, Kongable G, Barch C, Braimah J, Brattina P, Daley S, Donnarumma R, Rapp K, Sailor S. Using the NIH Stroke Scale to assess stroke patients. The NINDS rt-PA Stroke Study Group. J Neurosci Nurs. 1997;29(6):384–392. https://doi.org/10.1097/01376517-199712000-00008 PMID: 9479660.Патент RU2703439 C1. Способ хирургического лечения злокачественного ишемического инсульта: опубл. 26.07.2021, Бюл. № 21 / Сехвейл Салах ММ, Гончарова ЗА. 10 с.Patent RU2703439 C1. Method of surgical treatment of malignant ischemic stroke : publ. 26.07.2021, bulletin N. 21 / Sehweil Salah MM, Goncharova ZA. 10 s. (Russian).Sehweil Salah MM, Goncharova ZA. How I do it: decompressive hemicraniectomy supplemented with resection of the temporal pole and tentoriotomy for malignant ischemic infarction in the territory supplied by the middle cerebral artery. Acta Neurochir (Wien). 2022;164(6):1653–1657. https://doi.org/10.1007/s00701-022-05152-7 PMID: 35171374; PMCID: PMC9160119.Sehweil Salah MM, Goncharova ZA. How I do it: decompressive hemicraniectomy supplemented with resection of the temporal pole and tentoriotomy for malignant ischemic infarction in the territory supplied by the middle cerebral artery. Acta Neurochir (Wien). 2022;164(6):1653–1657. https://doi.org/10.1007/s00701-022-05152-7 PMID: 35171374; PMCID: PMC9160119.Vahedi K, Vicaut E, Mateo J, Kurtz A, Orabi M, Guichard J.-P, Boutron C, Couvreur G, Rouanet F, Touzé E, Guillon B, Carpentier A, Yelnik A, George B, Payen D, Bousser M-G Sequential-Design, multicenter, randomized, controlled trial of early decompressive carniectomy in malignant middle cerebral artery infarction (DECIMAL trial). Stroke. 2007;38(9):2506–2517. https://doi.org/10.1161/STROKEAHA.107.485235 PMID: 17690311.Vahedi K, Vicaut E, Mateo J, Kurtz A, Orabi M, Guichard J.-P, Boutron C, Couvreur G, Rouanet F, Touzé E, Guillon B, Carpentier A, Yelnik A, George B, Payen D, Bousser M-G Sequential-Design, multicenter, randomized, controlled trial of early decompressive carniectomy in malignant middle cerebral artery infarction (DECIMAL trial). Stroke. 2007;38(9):2506–2517. https://doi.org/10.1161/STROKEAHA.107.485235 PMID: 17690311.Hofmeijer J, Kappelle L J, Algra A, Amelink GJ, van Gijn J, van der Worp HB. Surgical decompression for space — occupying cerebral infarction (the hemicraniectomy after middle cerebral artery infarction with life — threating edema trial (HAMLET): A multicentre, open, randomized trial. Lancet Neurol. 2009;8(4):326–333. https://doi.org/10.1016/S14744422(09)70047-X PMID: 19269254.Hofmeijer J, Kappelle L J, Algra A, Amelink GJ, van Gijn J, van der Worp HB. Surgical decompression for space — occupying cerebral infarction (the hemicraniectomy after middle cerebral artery infarction with life — threating edema trial (HAMLET): A multicentre, open, randomized trial. Lancet Neurol. 2009;8(4):326–333. https://doi.org/10.1016/S14744422(09)70047-X PMID: 19269254.Middelaar TV, Richard E, van der Worp WH, van den Munckhof P, Nieuwkerk PT, Visser MC, Stam J, Nederkoorn PJ. Quality of life after surgical decompression for spaceoccupying middle cerebral artery infarct: A cohort study. BMC Neurol. 2015;15:156. https://doi.org/10.1186/s12883-015-0407-0 PMID: 26311142. PMCID: PMC4551524.Middelaar TV, Richard E, van der Worp WH, van den Munckhof P, Nieuwkerk PT, Visser MC, Stam J, Nederkoorn PJ. Quality of life after surgical decompression for spaceoccupying middle cerebral artery infarct: A cohort study. BMC Neurol. 2015;15:156. https://doi.org/10.1186/s12883-015-0407-0 PMID: 26311142. PMCID: PMC4551524.Lin J, Frontera JA. Decompressive hemicraniectomy for large hemispheric strokes. Stroke. 2021;52(4):1500–1510. https://doi.org/10.1161/STROKEAHA.120.032359 PMID: 33719518.Lin J, Frontera JA. Decompressive hemicraniectomy for large hemispheric strokes. Stroke. 2021;52(4):1500–1510. https://doi.org/10.1161/STROKEAHA.120.032359 PMID: 33719518.Сехвейл Салах ММ, Гончарова ЗА. Особенности клинической картины злокачественного ишемического инсульта в бассейне средней мозговой артерии. Российский нейрохирургический журнал им. профессора А.Л. Поленова.2022;14(2):72–79. https://doi.org/10.56618/20712693_2022_14_3_72Sekhvejl Salakh MM, Goncharova ZA. Specifi c clinical presentation of malignant ischemic infarction in the territory supplied by the middle cerebral artery. The Russian Neurosurgical Journal named after prof. A.L. Polenov. 2022;14(2):72–79(Russian). https://doi.org/10.56618/20712693_2022_14_3_72Jung JW, Kang L, Park J, Lee S, Jeon S. Intracranial pressure trends and clinical outcomes after decompressive hemicraniectomy in malignant middle cerebral artery infarction. Annals of intensive care. 2024;14:176. http://doi.org/10.1186/s13613-02401412-0Jung JW, Kang L, Park J, Lee S, Jeon S. Intracranial pressure trends and clinical outcomes after decompressive hemicraniectomy in malignant middle cerebral artery infarction. Annals of intensive care. 2024;14:176. http://doi.org/10.1186/s13613-02401412-0Mostofi K, Shirbache K, Shirbacheh A, Peyravi M. Neurosurgical treatment of cerebellar infarct: open craniectomy versus endoscopic surgery. Surg Neurol Int. 2024;15:442. http://doi.org/10.25259/SNI_740_2024 PMID: 39640310. PMCID: PMC11618802.Mostofi K, Shirbache K, Shirbacheh A, Peyravi M. Neurosurgical treatment of cerebellar infarct: open craniectomy versus endoscopic surgery. Surg Neurol Int. 2024;15:442. http://doi.org/10.25259/SNI_740_2024 PMID: 39640310. PMCID: PMC11618802.Крылов ВВ, Никитин АС, Дашьян ВГ, Буров СА, Петриков СС, Асратян СА. Хирургия массивного ишемического инсульта. М.: ГЭОТАР-Медиа, 2016. 136 с.Krylov VV, Nikitin AS, Dashyan VG, Burov SA, Petrikov SS, Asratyan SA. Surgery of Massive Ischemic Stroke. Moscow: GEOTAR-Media Publ.; 2016. 136 p. (Russian).Крылов ВВ, Петриков СС, Талыбов АЭ, Пурас ЮВ, Солодов АА, Левченко ОВ, Григорьева ЕВ, Кордонский АЮ. Современные принципы хирургии тяжелой черепно-мозговой травмы. Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь». 2013;4:39–47.Krylov VV, Petrikov SS, Talybov AE, Puras YuV, Solodov AA, Levchenko OV, Grigor’eva EV, Kordonskij AYu. Modern principles of surgery severe craniocerebral trauma. Russian Sklifosovsky Journal “Emergency Medical Care”. 2013;4:39–47 (Russian).Petzold A. Glial fi brillary acidic protein is a body fl uid biomarker for glial pathology in human disease. Brain Res. 2015;1600:17– 31. http://doi.org/10.1016/j.brainres.2014.12.027Petzold A. Glial fi brillary acidic protein is a body fl uid biomarker for glial pathology in human disease. Brain Res. 2015;1600:17– 31. http://doi.org/10.1016/j.brainres.2014.12.027Yang Z, Wang K. Glial fi brillary acidic protein: from intermediate fi lament assembly and gliosis to neurobiomarker. Trends Neurosci. 2015;38(6):364–374. http://doi.org/10.1016/j.tins.2015.04.003Yang Z, Wang K. Glial fi brillary acidic protein: from intermediate fi lament assembly and gliosis to neurobiomarker. Trends Neurosci. 2015;38(6):364–374. http://doi.org/10.1016/j.tins.2015.04.003Сосновский ЕА, Пурас ЮВ, Талыпов АЭ. Биохимические маркеры черепно-мозговой травмы. Нейрохирургия. 2014;2:83–90.Sosnovskij EA, Puras YuV, Talypov AE Biochemical markers of traumatic brain injury. Neurosurgery. 2014;2:83–90 (Russian).Лобзин ВЮ, Карев ВЕ. Иммуно-гистохимическая верификация нейродегенративных и микроциркуляторных изменений при деменциях. Вестник Российской военно-медицинской академии. 2015;4(52):14–20.Lobzin VYu, Karev VE. Immunohistochemical evaluation of neurodegenerative and vascular lesions in dementias. Bulletin of the Russian Military Medical academy. 2015;4(52):14–20 (Russian).Любимова НВ, Тимофеев ЮС, Кушлинский НЕ. Глиофибриллярный кислый протеин в сыворотке крови больных с опухолями головного мозга и неврологическими заболеваниями неопухолевой этиологии. Клиническая лабораторная диагностика. 2016;61(8):466–469.Lyubimova NV, Timofeev YUS, Kushlinskij NE. The glio-fi brillar acid protein in blood serum of patients with brain tumors and neurological diseases of non-tumorous etiology. Russian clinical Laboratory Diagnostics. 2016;61(8):466–469 (Russian).Винник ЮС, Салмина АБ, Теплякова ОВ, Дробушевская АИ, Малиновская НА, Пожиленкова ЕА, Моргун АВ, Гитлина АГ. Динамика локальной экспрессии коннексина — 43 и рецепторов основного фактора роста фибробластов у больных с гнойно-воспалительными заболеваниями кожи и мягких тканей на фоне сахарного диабета 2-го типа. Вестник хирургии им. И.И. Грекова. 2014;173(4):47–52. https://doi.org/10.24884/0042-4625-2014-173-4-47-52Vinnik YUS, Salmina AB, Teplyakova OV, Drobushevskaya AI, Malinovskaya NA, Pozhilenkova EA, Morgun AV, Gitlina AG. Dynamics of local expression of connexin — 43 and basic fi broblast growth factor receptors in patients with skin and soft-tissue infections against the background of diabetes mellitus type II. Grekov’s Bulletin of Surgery. (Vestnik khirurgii im. I.I. Grekova). 2014;173(4):47–52 (Russian). https://doi.org/10.24884/00424625-2014-173-4-47-52Шаповалова ЕЮ, Кутузова ЛА, Василенко СА, Барановский АГ. Клинические аспекты экспрессии коннексинов 40, 37, 43, 45 в эмбриональной и взрослой почках. Журнал анатомии и гистопатологии. 2023;12(3):96–102. https://doi.org/10.18499/2225-7357-2023-12-3-96-102Shapovalova EYU, Kutuzova LA, Vasilenko SA, Baranovskij AG. Clinical Aspects of Connexins 37, 40, 43, 45 Expression in the embryonic and Adult Kidneys. Journal of Anatomy and Histopathology. (Zhurnal anatomii i gistopatologii). 2023;12(3):96– 102 (Russian). https://doi.org/10.18499/2225-7357-2023-12-396-102Kirichenko EY, Logvinov AK, Sehweil SMM, Bragin DE, Logvinova IK. Analysis of Connexin 43 and spermine co-localization in glioblastomas. Adv Exp Med Biol. 2024;1463:279–284. http://doi.org/10.1007/978-3-031-67458-7_46Kirichenko EY, Logvinov AK, Sehweil SMM, Bragin DE, Logvinova IK. Analysis of Connexin 43 and spermine co-localization in glioblastomas. Adv Exp Med Biol. 2024;1463:279–284. http://doi.org/10.1007/978-3-031-67458-7_46Price GW, Potter JA, Williams BM, Cliff CL, Squires PE, Hills CE. Connexin-mediated cell communication in the kidney: a potential therapeutic target for future intervention of diabetic kidney disease: Joan Mott Prize Lecture. Exp Physiol. 2020;105(2):219–229. http://doi.org/10.1113/EP087770Price GW, Potter JA, Williams BM, Cliff CL, Squires PE, Hills CE. Connexin-mediated cell communication in the kidney: a potential therapeutic target for future intervention of diabetic kidney disease: Joan Mott Prize Lecture. Exp Physiol. 2020;105(2):219–229. http://doi.org/10.1113/EP087770Nwosu C, Kirichenko E, Bachurin S, Petrushan M, Ermakov A, Nabiullina R, Kaplya M, Logvinov A, Rodkin S. Investigation of the Expression, Localization, and Acidosis-Associated Conformational Changes in Connexin 43 in Traumatic Brain Injury with the Development of a Neural Network Model for Assessing Systemic Infl ammation. Int J Mol Sci. 2025;26(18):8855. https://doi.org/10.3390/ijmss26188855Nwosu C, Kirichenko E, Bachurin S, Petrushan M, Ermakov A, Nabiullina R, Kaplya M, Logvinov A, Rodkin S. Investigation of the Expression, Localization, and Acidosis-Associated Conformational Changes in Connexin 43 in Traumatic Brain Injury with the Development of a Neural Network Model for Assessing Systemic Infl ammation. Int J Mol Sci. 2025;26(18):8855. https://doi.org/10.3390/ijmss26188855Brander JM, Houdek P, Husing B, Kaiser C, Moll I. Connexins 26, 30, and 43: Diff erences among spontaneous, chronic, and accelerated human wound healing. J Invest Dermatol. 2004;122(5):1310–1320. https://doi.org/10.1111/j.0022-202X.2004.22529.xBrander JM, Houdek P, Husing B, Kaiser C, Moll I. Connexins 26, 30, and 43: Diff erences among spontaneous, chronic, and accelerated human wound healing. J Invest Dermatol. 2004;122(5):1310–1320. https://doi.org/10.1111/j.0022-202X.2004.22529.xIbrahum F, Menezes S, Buhnerkempe M, Fifer A, Meyer K, Allam H. Systematic white blood cell count as a biomarker for malignant cerebral edema in large vessel ischemic MCA stroke. J Stroke Cerebrovasc Dis. 2022;31(8):106550. https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106550Ibrahum F, Menezes S, Buhnerkempe M, Fifer A, Meyer K, Allam H. Systematic white blood cell count as a biomarker for malignant cerebral edema in large vessel ischemic MCA stroke. J Stroke Cerebrovasc Dis. 2022;31(8):106550. https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106550

The authors declare that there are no conflicts of interest present.