Case Series of Post-Thrombolysis Patients Undergoing Hemicraniectomy for Malignant Anterior Circulation Ischaemic Stroke英文文献资料.docVIP

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Case Series of Post-Thrombolysis Patients Undergoing Hemicraniectomy for Malignant Anterior Circulation Ischaemic Stroke英文文献资料.doc

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Case Series of Post-Thrombolysis Patients Undergoing Hemicraniectomy for Malignant Anterior Circulation Ischaemic Stroke英文文献资料

HindawiPublishingCorporation CardiovascularPsychiatryandNeurology Volume2011,ArticleID254569,4pages doi:10.1155/2011/254569 CaseReport CaseSeriesofPost-ThrombolysisPatients UndergoingHemicraniectomyforMalignantAnterior CirculationIschaemicStroke A.Williams, M.Sittampalam, N.Barua, andA.MohdNor 1 2 3 2 1 2 3 DepartmentofNeurosurgery,DerrifordHospital,Plymouth,PL68DH,UK DepartmentofNeurology,DerrifordHospital,Plymouth,PL68DH,UK DepartmentofNeurosurgery,FrenchayHospital,Bristol,BS161LE,UK CorrespondenceshouldbeaddressedtoA.Williams,apwilliams13@ Received30September2010;Revised31October2010;Accepted13February2011 AcademicEditor:GjumrakchAliev Copyright?2011A.Williamsetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. While ischaemic stroke remains a leading cause of death and disability, there have been recent advancements in treatment modalitiesincludingthrombolysisanddecompressivehemicraniectomy.AretrospectivereviewofpatientstreatedinourNHS teachinghospital,inPlymouth(UK),overa2yearperiodidenti?ed17thrombolysedpatients,ofwhomtwohadundergone subsequent decompressive hemicraniectomy. These were non-dominant hemisphere strokes in young patients, aged 51 and 57. Initial NIHSS scores were 16 and 17, and they received thrombolysis at 2hrs 42min and 5hrs 10min post onset of symptomsrespectively.CTimagingdemonstratedcerebralswellingwithsigni?cantmidlineshiftinbothcases,anddecompressive hemicraniectomywasundertakenat29hrs8minand27hrs30minpost-thrombolysis.Wefoundnosigni?cantintra-operative complicationsattributabletoprioruseofthrombolytics.Bothpatientshavehadacceptablepsychologicalandphysicaloutcomes, withBarthelIndexscoresof40and25,andMMSEscoresof29/30and27/30.Weconcludethattheuseofthrombolytictherapy doesnotcontra-indicatesubsequentdecompressivehemicraniectomyinwellselectedpatientswithnon-domi