恶性大脑中动脉梗死静脉溶栓不成功后减压半脑切除术1例

S.M. SEHWEIL
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摘要

方法:脑梗死(CI)患者的金标准治疗是静脉溶栓,在改善功能状态方面优于标准治疗。恶性大脑中动脉梗死(MMCAI)的特征是MCA供血区域的50%或更多的缺血性损伤,这反过来又是溶栓治疗的禁忌症。当患者在通过计算机断层扫描识别低密度病变之前的治疗窗口内入院时,及时检测MMCAI具有挑战性。因此,这些患者接受静脉溶栓治疗。文章描述了一个成功的减压半颅骨切除术(DHC)患者无效,无并发症的静脉溶栓治疗MMCAI。关键词:恶性缺血性卒中,大脑中动脉,降压性半脑切除术,溶栓。
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DECOMPRESSIVE HEMICRANIECTOMY AFTER UNSUCCESSFUL INTRAVENOUS THROMBOLYSIS OF MALIGNANT MIDDLE CEREBRAL ARTERY INFARCTION: A CASE REPORT
Methods: The gold standard treatment for patients with cerebral infarction (CI) is intravenous thrombolysis, and it is superior to standard therapy in improving functional status. Malignant middle cerebral artery infarction (MMCAI) is characterized by ischemic injury of 50% or more of the territory supplied by MCA, which, in turn, is a contraindication to thrombolytic therapy. When patients are admitted to the hospital within the therapeutic window before identification of a hypodense lesion by computed tomography, detecting the MMCAI promptly is challenging. Consequently, these patients receive intravenous thrombolysis. The article describes a successful decompressive hemicraniectomy (DHC) in a patient with MMCAI following ineffective, uncomplicated intravenous thrombolysis. Keywords: Malignant ischemic stroke, middle cerebral arter, decompressive hemicraniectomy, thrombolysis.
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