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https://www.selleckchem.com/products/ly364947.html 047), an irregular aneurysm (p = 0.004) and the presence of a daughter dome (p = 0.002) were associated with aneurysm rupture. The multivariate analysis showed that a larger size ratio (OR 1.324, 95 % CI, 1.062-1.651; p = 0.013) and the presence of daughter dome (OR 2.462, 95 % CI, 1.123-5.398; p = 0.024) were independently associated with ruptured aneurysms. The threshold of the size ratio for discriminating ruptured and unruptured aneurysms was 2.53 (p  less then  0.001). CONCLUSIONS The size ratio and the presence of a daughter dome were independent predictors of the rupture of MCA bifurcation aneurysms. These parameters may contribute to the evaluation of the risk of rupture of aneurysms. OBJECTIVE Decompressive hemicraniectomy (DH) effectively alleviates increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI) and malignant middle cerebral artery (MCA) infarction. Its role in the management of spontaneous intracranial hemorrhage (SICH) however remains uncertain. This study aims to review the efficacy and safety of DH without clot evacuation in SICH. PATIENTS AND METHODS A systematic literature search of PubMEd, EMBASE, Scopus and Cochrane Library Central Register of Control Trials was performed. Studies were reviewed independently for methodology, inclusion and exclusion criteria and end points. Primary endpoint was overall mortality. Secondary endpoint was functional outcome using modified Rankin scale (mRs) or Glasgow outcome scale (GOS). RESULTS Nine studies with a total of 146 patients who underwent DH without clot evacuation include 1 RCT, 3 cohort, 2 case series, and 3 case-control studies. Age range was 40-60 years, with majority of patients presenting with a relatively depressed preoperative sensorium (GCS 6-8), large hematoma volumes (>50 mL), and deep locations (basal ganglia and thalamus). Pooled analysis showed a favorable outcome in 53 %, a mortality rate of 26 % and a co

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