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Middle cerebral artery infarction and ipsilateral posterior cerebral artery infarction (Case report: successful hemicraniestomy in patient older than 60 years of age)

Cerebral stroke is the third cause of death in the world and is the most common cause of death among diseases of the central nervous system. Among cases of supratentorial infarction, 10 - 15% involve the entire middle cerebral artery (MCA) territory. | Journal of military pharmaco-medicine MIDDLE CEREBRAL ARTERY INFARCTION AND IPSILATERAL POSTERIOR CEREBRAL ARTERY INFARCTION: Case report: Successful hemicraniestomy in patient older than 60 years of age Truong Da*; Bui Quang Tuyen** Vu Van Hoe**; Bui Quang Dung** SUMMARY Cerebral stroke is the third cause of death in the world and is the most common cause of death among diseases of the central nervous system. Among cases of supratentorial infarction, 10 - 15% involve the entire middle cerebral artery (MCA) territory. The occlusion of MCA leads to a mortality of around 80%. Over the last 10 years, decompressive hemicraniectomy for management of MCA infarction has been implemented at many neurosurgical centres all over the world. Although the mortality rate in patients ≥ 60 years of age was high, the result of surgical decompression showed an improvement in functional outcome and mortality rate compared with medical management. Of 75 patients who underwent decompressive craniectomy for middle cerebral artery infarction, one case suffered from MCA and ipsilateral posterior cerebral artery infarction. This case was successfully operated. We report the rare case and review the relevant literature. * Keywords: Middle cerebral artery infarction; Cerebral stroke; Ipsilateral posterior cerebral artery infarction. CASE REPORT A 61 year-old man (dwelled at 232 Nguyen Cong Tru street, Nguyen Thai Binh ward, district 1, Hochiminh City) was referred to the emergency unit of 115 Hospital in Hochiminh City on September 13, 2015 with symptoms of sudden weakness of the right hemibody. On the image of the computer tomography scans (CT), there was an infarction of the left middle cerebral artery. The patient received medical treatment with anticoagulant, fluid replacement and antibrain edema measures. After 3 days, the patient deteriorated with Glasgow Coma Scale (GOS) score dropped down 3 points. Repeated computer tomography (CT) showed evidence of the left middle cerebral artery