Marilyn A Tan1, Aida M Salonga, Roland Dominic G Jamora. 1. Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Taft Avenue, Ermita, Manila, 1000, Philippines. marlmd@yahoo.com
Abstract
INTRODUCTION: We report on the case of a 2-year 5-month-old girl with congenital heart disease who developed left middle cerebral artery occlusion and cerebral hemorrhagic infarction a day after ventricular septal defect patch closure. RESULTS: Cranial computed tomography scan revealed an acute hemorrhagic infarct over the left middle cerebral artery territory with midline shift to the right. Since medical treatment failed, decompressive hemicraniectomy with duraplasty was performed, successfully reversing herniation. Decompressive surgery allows extracranial expansion of the swollen brain and relieves CSF space compression. We believe this to be the youngest reported patient to undergo decompressive hemicraniectomy for middle cerebral artery territory infarction. Although the patient survived, her functional outcome was poor. CONCLUSION: Decompressive hemicraniectomy can be lifesaving and should be considered as an alternative therapy for patients with brain swelling refractory to medical management.
INTRODUCTION: We report on the case of a 2-year 5-month-old girl with congenital heart disease who developed left middle cerebral artery occlusion and cerebral hemorrhagic infarction a day after ventricular septal defect patch closure. RESULTS: Cranial computed tomography scan revealed an acute hemorrhagic infarct over the left middle cerebral artery territory with midline shift to the right. Since medical treatment failed, decompressive hemicraniectomy with duraplasty was performed, successfully reversing herniation. Decompressive surgery allows extracranial expansion of the swollen brain and relieves CSF space compression. We believe this to be the youngest reported patient to undergo decompressive hemicraniectomy for middle cerebral artery territory infarction. Although the patient survived, her functional outcome was poor. CONCLUSION: Decompressive hemicraniectomy can be lifesaving and should be considered as an alternative therapy for patients with brain swelling refractory to medical management.
Authors: K J Ottenbacher; M E Msall; N Lyon; L C Duffy; J Ziviani; C V Granger; S Braun; R C Feidler Journal: Arch Phys Med Rehabil Date: 2000-10 Impact factor: 3.966
Authors: Wendy C Ziai; John D Port; John A Cowan; Ira M Garonzik; Anish Bhardwaj; Daniele Rigamonti Journal: J Neurosurg Anesthesiol Date: 2003-01 Impact factor: 3.956
Authors: M B Pranesh; S Dinesh Nayak; V Mathew; B Prakash; M Natarajan; V Rajmohan; R Murali; A Pehlaj Journal: J Neurol Neurosurg Psychiatry Date: 2003-06 Impact factor: 10.154
Authors: E Uhl; F W Kreth; B Elias; A Goldammer; R G Hempelmann; M Liefner; G Nowak; M Oertel; K Schmieder; G-H Schneider Journal: J Neurol Neurosurg Psychiatry Date: 2004-02 Impact factor: 10.154
Authors: Sacit Bulent Omay; Geneive M Carrión-Grant; Gregory A Kuzmik; Michael Fu; Ryan Grant; Joseph L Schindler; Michael L Diluna; Charles C Duncan; Ketan R Bulsara Journal: Neurosurg Rev Date: 2012-08-11 Impact factor: 3.042
Authors: Ralph Rahme; Lincoln Jimenez; Umair Bashir; Opeolu M Adeoye; Todd A Abruzzo; Andrew J Ringer; Brett M Kissela; Jane Khoury; Charles J Moomaw; Heidi Sucharew; Simona Ferioli; Matthew L Flaherty; Daniel Woo; Pooja Khatri; Kathleen Alwell; Dawn Kleindorfer Journal: Childs Nerv Syst Date: 2012-08-23 Impact factor: 1.475