Response to Drs. Lahiri and Lyden


We thank Drs. Lahiri and Lyden for their valuable comments regarding the benefit of hemicraniectomy in patients over the age of 60 years. As the authors mentioned, there was a trend toward higher odds of favorable outcome (modified Rankin Scale scores of 0-3) among those randomized to hemicraniectomy compared with conservative treatment in trials that permitted recruitment of patients aged 60 years or older (303 subjects analyzed; odds ratio 1.87, 95% confidence interval .91-3.86, P = .09). We agree that the data did not support a significant benefit but only a trend toward higher rates of favorable outcomes.


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