[Emergency embolectomy in embolic occlusion of the middle cerebral artery].
The natural course of embolic occlusion of the middle cerebral artery (MCA) has many variations, which include the frequent appearance of hemorrhagic infarction. There are also fatal cases among which severe ischemic edema is found. There haven's been many cases reported of MCA embolectomy in the acute stage, and findings concerning them have been very complicated and hard to analyze. Nevertheless there certainly exist cases where remarkable improvement of neurological signs is shown soon after the procedure. Five cases of emergency embolectomy have been undergone in our hospital in the past 2 years. The results were better than results obtained in cases where embolectomy was not performed. Three male and two female cases are the objectives, whose average age was 61 +/- 6 years (ranging from 54 to 67 years). The left side of the MC was involved in three cases and the right in two, and all cases had past history of heart diseases which may have been the embolic source. Each case had undergone CT scan soon after admission to make sure not to be the other type of intracranial lesion. Cerebral angiography was performed next, to discover the site of the occlusion and the degree of collateral circulation. Emergency embolectomy was performed as soon as possible in every case. The functional outcome was estimated from the ADL three months later using the international fifth degree grading.


RESULTS
The period from onset to recanalization ranges between 4.5 to 11 hours (average 6.9 +/- 2.5 hours). Good MC recanalization was demonstrated in each case angiographically within a week after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)
Kitami
K
K
Department of Emergency Medicine, Sapporo City General Hospital.
Tsuchida
H
H
Sohma
T
T
Hamajima
I
I
Sakamaki
Y
Y
Takeda
T
T
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D004630:Emergencies; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed