title: Decompressive craniectomy 116 h after malignant middle cerebral artery infarction.
abstract: The optimal timing of decompressive craniectomy in pediatric patients after presentation with malignant middle cerebral artery infarction is unknown. We report herein the case of a previously healthy 6-year-old Japanese girl who had good outcome after emergency decompressive craniectomy 116 h after malignant middle cerebral artery infarction. This case suggests that the timing of decompressive craniectomy can be delayed until deterioration of neurological findings and, compared with adults, a more prolonged time course for surgical intervention might be acceptable.
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamaguchi
authors.affiliation: Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Akutsu
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Kusumoto
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kajihara
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Yamaguchi
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takeda
authors.affiliation: Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawamura
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Uetani
mesh_terms: D002533:Cerebral Angiography; D002648:Child; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: decompressive craniectomy; focal cerebral arteriopathy of childhood; malignant middle cerebral artery infarction; stroke