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Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction

Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved treatment for acute ischemic stroke within 4.5 h of symptoms onset. Decompressive craniectomy (DC) has been shown as an effective therapeutic modality in malignant middle cerebral artery (MCA) infarction. As rt-P...

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Autores principales: Baharvahdat, Humain, Etemadrezaie, Hamid, Zabyhian, Samira, Valipour, Zahra, Ganjeifar, Babak, Mousavi Mirzaye, Seyed Mohammad, Sasannejad, Payam, Ghandehari, Kavian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Iranian Neurological Association 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187327/
https://www.ncbi.nlm.nih.gov/pubmed/25295154
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author Baharvahdat, Humain
Etemadrezaie, Hamid
Zabyhian, Samira
Valipour, Zahra
Ganjeifar, Babak
Mousavi Mirzaye, Seyed Mohammad
Sasannejad, Payam
Ghandehari, Kavian
author_facet Baharvahdat, Humain
Etemadrezaie, Hamid
Zabyhian, Samira
Valipour, Zahra
Ganjeifar, Babak
Mousavi Mirzaye, Seyed Mohammad
Sasannejad, Payam
Ghandehari, Kavian
author_sort Baharvahdat, Humain
collection PubMed
description Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved treatment for acute ischemic stroke within 4.5 h of symptoms onset. Decompressive craniectomy (DC) has been shown as an effective therapeutic modality in malignant middle cerebral artery (MCA) infarction. As rt-PA could result in hemorrhagic complication during or after any surgery DC may be associated with severe bleeding after intravenous thrombolysis. Case Description: A 57-year-old woman was presented 90 min after the sudden onset of left hemiplegia. Despite intravenous thrombolytic therapy, she lost consciousness within 48 h and brain CT scan showed a right malignant MCA infarction associated with a small bleeding. DC was performed without any complication. The patient improved dramatically. Conclusion: DC could be done safety for malignant MCA infarction after unsuccessful intravenous thrombolytic therapy even the later was complicated with intra-infarction hemorrhage.
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spelling pubmed-41873272014-10-07 Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction Baharvahdat, Humain Etemadrezaie, Hamid Zabyhian, Samira Valipour, Zahra Ganjeifar, Babak Mousavi Mirzaye, Seyed Mohammad Sasannejad, Payam Ghandehari, Kavian Iran J Neurol Case Report Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved treatment for acute ischemic stroke within 4.5 h of symptoms onset. Decompressive craniectomy (DC) has been shown as an effective therapeutic modality in malignant middle cerebral artery (MCA) infarction. As rt-PA could result in hemorrhagic complication during or after any surgery DC may be associated with severe bleeding after intravenous thrombolysis. Case Description: A 57-year-old woman was presented 90 min after the sudden onset of left hemiplegia. Despite intravenous thrombolytic therapy, she lost consciousness within 48 h and brain CT scan showed a right malignant MCA infarction associated with a small bleeding. DC was performed without any complication. The patient improved dramatically. Conclusion: DC could be done safety for malignant MCA infarction after unsuccessful intravenous thrombolytic therapy even the later was complicated with intra-infarction hemorrhage. Iranian Neurological Association 2014-04-03 /pmc/articles/PMC4187327/ /pubmed/25295154 Text en Copyright © 2014 Iranian Neurological Association, and Tehran University of Medical Sciences This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Baharvahdat, Humain
Etemadrezaie, Hamid
Zabyhian, Samira
Valipour, Zahra
Ganjeifar, Babak
Mousavi Mirzaye, Seyed Mohammad
Sasannejad, Payam
Ghandehari, Kavian
Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction
title Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction
title_full Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction
title_fullStr Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction
title_full_unstemmed Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction
title_short Decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction
title_sort decompressive craniectomy after unsuccessful intravenous thrombolysis of malignant cerebral infarction
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187327/
https://www.ncbi.nlm.nih.gov/pubmed/25295154
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