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Case Reports
Anesthetic Management of a Patient With Ongoing Thrombolytic Therapy During Decompressive Craniectomy: A Case Report.
- Nicole Souper, Claudia Jiménez, and Felipe Maldonado.
- From the Department of Anesthesia, Faculty of Medicine, Clinical Hospital of the University of Chile, Santiago, Chile.
- A A Pract. 2018 Dec 1; 11 (11): 304-308.
AbstractDecompressive craniectomy (DC) is a therapeutic alternative for reducing intracranial pressure after a middle cerebral artery stroke. If thrombolytic therapy is administered, craniectomy is usually postponed for at least 24 hours due to a risk of severe bleeding. We describe a case in which DC was performed on a 38-year-old man who received thrombolytic therapy for an ischemic stroke involving the middle cerebral artery. His neurological and hemodynamic status worsened during its administration, and DC was performed 6 hours after thrombolysis was performed. Fibrinolytic coagulopathy was successfully managed by monitoring fibrinogen levels and with the administration of cryoprecipitate and tranexamic acid.
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