| A Case of Extensive Cerebral
Infarction Associated with Acute Aortic Dissection Responding
to External Decompression and Mild Brain Hypothermia |
(Department of Cardiovascular Surgery, Sasebo Chuo
Hospital, Sasebo, Japan)
| Manabu Noguchi |
Ryuuichiro Shibata |
Miyoko Iwamatsu |
|
A 56-year-old Japanese woman underwent
hemi-arch replacement with selective cerebral perfusion for acute
aortic dissection of DeBakey type I. A postoperative computed
tomographic scan of the brain showed extensive infarction of
the right hemisphere, a midline shift, and right uncal herniation.
The patient received right fronto-temporo-parietal craniectomy
and external decompression followed by mild brain hypothermia,
targeting a rectal temperature of 34℃. Despite residual left
hemiparesis, she became alert and successfully recovered. She
was discharged 147 days after the operation. We conclude that
external decompression with mild brain hypothermia was therapeutically
useful, with no major complications, for the treatment of extensive
cerebral infarction associated with acute aortic dissection.
Jpn. J. Cardiovasc. Surg. 32：148 -151 (2003) |
|
