Abstract: Objective To analyze the effect of 3D-Slicer-assisted localization of decompression range of bone flap in the treatment for massive cerebral infarction in the elderly patients. Methods One hundred elderly patients with massive cerebral infarction who did not receive 3D-Slicer treatment from January 2018 to December 2020 were selected as the control group, and 50 patients treated with 3D-Slicer were enrolled as the observation group. The control group was treated with standard large bone flap decompression, and the observation group was assisted by 3D-Slicer treatment on the basis of the control group. The displacement of midline structure was observed. The quality of short-term prognosis and neurological function were evaluated and compared between the two groups. Results The intracranial pressure in the observation group was significantly lower than that in the control group at different time points after operation (P<0.01). After treatment, the Glasgow Coma Scale (GCS) score and good recovery rate in the observation group were significantly higher than those in the control group (P<0.01). Logistic regression analysis showed that age, extent of involvement, GCS score, midline displacement and treatment plan were the independent influencing factors of the quality of prognosis of the patients with massive cerebral infarction (P<0.05). Conclusions 3D-Slicer-assisted localization of decompression range of bone flap in the elderly patients massive cerebral infarction can effectively improve the clinical efficacy and prognostic quality, and the age, extent of involvement, GCS score, midline displacement and treatment plan might affect the prognostic quality.

Key words: 3D-Slicer-assisted localization, massive cerebral infarction, decompressive craniectomy, poor prognosis