급성뇌경색의 수술적 처치
Surgical Management of Acute Infarction
대한뇌혈관학회지 2001년 3권 2호 p.119 ~ 126
소속 상세정보
김국기/Gook Ki Kim
KMID : 0890520010030020119
Abstract
About 15% of the patients with the middle cerebral artery or internal carotid artery territory acute infarction can lead to massive cerebral edma with raised intracranial pressure and progression to coma or death within 3-5 days of the original
ictus.
Decompressive wide unilateral frontotemporoparietooccipital craniectomy with duroplasty should be given in appropriate time if patient had no effect incombating transtentorial herniation with medical therapy such as mannitol and hyperventilation.
Occlusion of posterior inferior cerebellar artery or vertebral artery and superior cerebellar artery can evolve into life-threatening brainstem compression or hydrocephalus from postinfarct cerebellar edema. Suboccipital decompressive craniectomy
with
resection of necrotic cerebellar tissue or extraventricular drainage may be an effective lifesaving procedure in case of no improvement with medical therapy. Very few cases of acute infarction with embolic occlusion of main trunk of middle
cerebral
artery which confirmed by angiography within 6-8 hours after onset may be considered to have embolectomy by open craniotomy.
키워드
악성뇌부종; 급성대뇌경색; 급성소뇌경색; 색전제거술; 편두개절제술; 후두하 감압두개골 절개술; Massive brain edema due to infarction; Acute cerebral infarction; Acute cerebeller infarction; Embolectomy; Hemicraniectomy; Suboccipital decompressive craniectomy
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