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Malignant middle cerebral artery infarct: A clinical case report

Title: Malignant middle cerebral artery infarct: A clinical case report
Authors: Kwan Yee (Queenie) Leung; Rosalind Elliott; Sheila Jala
Source: Australasian Journal of Neuroscience, Vol 28, Iss 1 (2018)
Publisher Information: Exeley Inc.
Publication Year: 2018
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: stroke; middle cerebral artery infarction; case study; critical care; critical illness; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571
Description: Background:Ischaemic stroke accounts for 87% of strokes and occurs when a clot or a thrombus blocks a blood vessel, cutting off blood flow to a part of the brain. If large areas of brain are affected, space-occupying oedema may result, leading to rapid neurological deterioration, coma and death. Malignant middle cerebral artery infarction (MMCAI) is a life-threating ischaemic stroke involving the whole middle cerebral artery (MCA) territory and comprises up to 10% of MCA infarctions.Methods:We report the case of a 62 year old female ‘Mary’ who presented with a MMCAI together with a summary of the most recent and relevant evidence for treatment options in terms of survival and quality of life for her. We also focus on the vital role of the nurse in Mary’s care and treatment.Results:Intravenous thrombolysis and endovascular clot retrieval (ECR) during the hyperacute phase have been shown to improve outcomes but Mary did not meet the criteria for thrombolysis and received unsuccessful ECR. Her neurological condition deteriorated so she underwent surgical decompression, which is one of the major advances for MMCAI treatment together with expert neuro critical care nursing. Mary made a good functional recovery, returning home to live independently.Conclusion:This case highlights the need to consider all contextual and patient preferences in relation to treatment options. In addition the case emphases the vital role the neuro critical care nurse specialist plays in the complex assessment and treatment of this patient who experienced a MMCAI and underwent complex interventions.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.exeley.com/exeley/journals/australasian_journal_of_neuroscience/28/1/pdf/10.21307_ajon-2017-008.pdf; https://doaj.org/toc/1032-335X; https://doaj.org/toc/2208-6781; https://doaj.org/article/9c735c08296245c7b762cfeceea9d98e
DOI: 10.21307/ajon-2017-008
Availability: https://doi.org/10.21307/ajon-2017-008; https://doaj.org/article/9c735c08296245c7b762cfeceea9d98e
Accession Number: edsbas.F5CD12C6
Database: BASE