Presentation
Hemiparesis, NIHSS 17.
Patient Data
Age: 45 years
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This study was performed in a peripheral hospital. Large right MCA territory infarct (ASPECTS = 2). Terminal right ICA occlusion with thromboembolism. 60 ml core infarct. Moderate penumbra.
Transferred for consideration of hemicraniectomy - and possibly for delayed time window ECR. Delays in transfer meant that if ECR was to be attempted it would only commence until over 8 hours post-onset.
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Large core, matched perfusion defect, NCCT changes with mass effect. Too late for ECR, candidate for decompressive hemicraniectomy.
From the case:
Large right MCA infarct and hemicraniectomy
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A right-sided hemicraniectomy has been performed.
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Progressive swelling with patchy contralateral infarcts.
Case Discussion
Subsequently found to have septic emboli to multiple organs.