PT  - JOURNAL ARTICLE
AU  - Urs Fischer
AU  - Philipp Taussky
AU  - Jan Gralla
AU  - Marcel Arnold
AU  - Caspar Brekenfeld
AU  - Michael Reinert
AU  - Niklaus Meier
AU  - Marie-Luise Mono
AU  - Gerhard Schroth
AU  - Heinrich P Mattle
AU  - Krassen Nedeltchev
TI  - Decompressive craniectomy after intra-arterial thrombolysis: safety and outcome
AID  - 10.1136/jnnp.2009.198648
DP  - 2011 Aug 01
TA  - Journal of Neurology, Neurosurgery &amp;amp; Psychiatry
PG  - 885--887
VI  - 82
IP  - 8
4099  - http://jnnp.bmj.com/content/82/8/885.short
4100  - http://jnnp.bmj.com/content/82/8/885.full
SO  - J Neurol Neurosurg Psychiatry2011 Aug 01; 82
AB  - Objectives Data on decompressive craniectomy (DC) after intra-arterial thrombolysis (IAT) for treatment of malignant middle cerebral artery (MCA) stroke are lacking.Methods The authors compared consecutive patients with middle cerebral artery (MCA) strokes who underwent decompressive craniectomy (DC) after IAT with DC patients without prior thrombolysis.Results Thirty of 2395 consecutive patients with acute ischaemic stroke or transient ischaemic attack were treated with DC because of space-occupying oedema 12–72 h after symptom onset. Fifteen patients underwent intra-arterial thrombolysis (IAT) prior to DC. Baseline characteristics did not differ between thrombolysed and non-thrombolysed patients except for lower National Institute of Health Stroke Scale score in non-thrombolysed patients (median National Institute of Health Stroke Scale 17 vs 14, p=0.033). The outcome at 3 months was favourable (modified Rankin scale 0–3) in seven (47%) thrombolysed patients and in four (27%) non-thrombolysed patients (p=0.45). Mortality and major complications after DC did not differ between the two groups (p&amp;gt;0.05). Older age (p=0.037) and previous hypertension (p=0.047) independently predicted unfavourable outcome in DC patients, but not IAT prior DC.Conclusions There was no difference of outcome of patients with DC with or without prior IAT. DC after IAT did not cause any more complications than DC without prior thrombolysis.