case series of post-thrombolysis patients undergoing hemicraniectomy for malignant anterior circulation ischaemic stroke接受hemicraniectomy post-thrombolysis系列病例的患者为恶性前循环缺血性中风.pdfVIP

Hindawi Publishing Corporation Cardiovascular Psychiatry and Neurology Volume 2011, Article ID 254569, 4 pages doi:10.1155/2011/254569 Case Report Case Series of Post-Thrombolysis Patients Undergoing Hemicraniectomy for Malignant Anterior Circulation Ischaemic Stroke A. Williams,1 M. Sittampalam,2 N. Barua,3 and A. Mohd Nor2 1 Department of Neurosurgery, Derriford Hospital, Plymouth, PL6 8DH, UK 2 Department of Neurology, Derriford Hospital, Plymouth, PL6 8DH, UK 3 Department of Neurosurgery, Frenchay Hospital, Bristol, BS16 1LE, UK Correspondence should be addressed to A. Williams, apwilliams13@ Received 30 September 2010; Revised 31 October 2010; Accepted 13 February 2011 Academic Editor: Gjumrakch Aliev Copyright © 2011 A. Williams et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. While ischaemic stroke remains a leading cause of death and disability, there have been recent advancements in treatment modalities including thrombolysis and decompressive hemicraniectomy. A retrospective review of patients treated in our NHS teaching hospital, in Plymouth (UK), over a 2 year period identified 17 thrombolysed patients, of whom two had undergone 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 2 hrs 42 min and 5 hrs 10 min post onset of symptoms respectively. CT imaging demonstrated cerebral swelling with significant midline shift in both cases, and decompressive hemicraniectomy was undertaken at 29 hrs 8 min and 27 h