Treatment Of Malignant Middle Cerebral Artery Infarction

DECOMPRESSIVE CRANIECTOMY FOR MALIGNANT MIDDLE CEREBRAL ARTERY INFARCTION INTRODUCTION Stroke represents a public health issue that is affecting both developed and developing countries. A lot money and time have been invested in attempts to improve outcome in these patients. The majority of patients are treated with medical management. There are however few patients in which an occlusion of the middle cerebral artery (MCA) can lead to progressive edema, mass effect and herniation of the brain. As a consequence of this progressive rise in intracranial pressure surgical decompression of the cranium is often considered creating a role for the neurosurgeon in the management of stroke patients. I will present a case of a young boy with an underlying predisposing factor who presented with malignant progression of an MCA infarct, that required surgical intervention. CASE A 14 year old boy presented to the Accident and Emergency department of the Kingston Public Hospital with a history of acute left sided weakness. He was known to have sickle cell disease with the HbSS genotype. He had previously presented with a stroke and had residual right sided weakness. There was no history of headaches fever, vomiting, chest or joint pain. He was admitted to the medical ward where treatment was instituted. On admission he had a Glasgow Coma Score (GCS) of 15 with grade 2 power (MRC) in the upper limbs and grade 3 (MRC) in the lower limbs. Radiological investigations wereShow MoreRelatedComplications Of Brain Surgery860 Words   |  4 Pagesstudies have drawn conclusions between certain patients’ characteristics and their prognosis. â€Æ' References Arac, A., Blanchard, V., Lee, M., Steinberg, G. K. (2009). Assessment of outcome following decompressive craniectomy for malignant middle cerebral artery infarction in patients older than 60 years of age. Neurosurgical Focus, 26(6). doi:10.3171/2009.3.focus0958 Ban, S. P., Son, Y., Yang, H., Chung, Y. S., Lee, S. H., Han, D. H. (2010). Analysis of complications following decompressive craniectomyRead MoreInternational Classification of Diseases Coding Ii10064 Words   |  41 Pagesparents carried the sickle-cell gene. O. The code for sickle-cell disease should be assigned. P. The patient received the sickle-cell gene from only one parent and is a carrier of the trait. 5. How should hemorrhagic disorder due to treatment with anticoagulants like Coumadin or heparin be coded? Q. D68.318 R. D68.32 and T45.515A S. D68.318 and T45.515A T. D68.32 6. A patient was admitted for lower gastrointestinal bleeding that is secondary to recurrentRead MoreUnit 2 study guide8637 Words   |  35 Pagesand posture? Emotions and behavior are controlled by the hypothalamus (p.455) The cerebellum is responsible for maintaining balance and posture (p.455) The reticular formation is essential for maintaining wakefulness and in conjunction with the cerebral cortex is referred to as the reticular activating system (p.450) The Broca speech area is rostral to the inferior edge of the premotor area on the inferior frontal gyrus. It is usually on the left hemisphere and is responsible for the motor aspectsRead MoreCase Study Essay33967 Words   |  136 Pagesdischarged from the hospital for exacerbated HF. Comprehensive patient education starting at admission is considered a standard of care and is mandated by The Joint Commission when providing care to hospitalized patients. The goal of the discharge treatment plan is to facilitate successful patient selfmanagement, minimize symptoms, and prevent readmission. CASE STUDY PROGRESS During the admission interview, the nurse makes a list of the medications M.G. took at home. ââ€"   Chart View Nursing Assessment:Read MoreHesi Practice31088 Words   |  125 Pagesthe knees are flexed. C. Atrophy of the lower leg muscles. D. Positive Homans sign. 7. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is A. psychotherapy. B. total abstinence. C. Alcoholics Anonymous (AA). D. aversion therapy. 8. A 23-month-old child is brought to the emergency department with suspected croup. Which assessment finding reflects increasing respiratoryRead More_x000C_Introduction to Statistics and Data Analysis355457 Words   |  1422 PagesParagraph 575 Graphing Calculator Explorations 580 11 Comparing Two Populations or Treatments 583 11.1 Inferences Concerning the Difference Between Two Population or Treatment Means Using Independent Samples 583 11.2 Inferences Concerning the Difference Between Two Population or Treatment Means Using Paired Samples 606 11.3 Large Sample Inferences Concerning a Difference Between Two Population or Treatment Proportions 619 11.4 Interpreting and Communicating the Results of Statistical Analyses