Neurosurgery
doi: 10.25005/2074-0581-2023-25-3-431-440
DECOMPRESSIVE HEMICRANIECTOMY AFTER UNSUCCESSFUL INTRAVENOUS THROMBOLYSIS OF MALIGNANT MIDDLE CEREBRAL ARTERY INFARCTION: A CASE REPORT

S.M. Sehweil

Department of Neurology and Neurosurgery, Rostov State Medical University, Rostov-on-Don, Russian Federation

Objective: 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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Authors' information:

Sehweil Salah Mohammed,
Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Neurology and Neurosurgery, Rostov State Medical University
Researcher ID: ABE-3405-2021
Scopus ID: 57226736867
ORCID ID: 0000-0003-3942-7442
SPIN: 2079-7476
Author ID: 646869
E-mail: salahsehweil@yandex.ru

Information about support in the form of grants, equipment, medications

The author did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Sehweil Salah Mohammed
Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Neurology and Neurosurgery, Rostov State Medical University

344022, Russian Federation, Rostov-on-Don, per. Nakhichevansky, 29

Tel.: +7 (928) 1065686

E-mail: salahsehweil@yandex.ru

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