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Updated: Feb 9, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
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Anesthetic Management of a Patient With Ongoing Thrombolytic Therapy During Decompressive Craniectomy: A Case Report

Nicole Souper1, Claudia Jiménez, Felipe Maldonado

  • 1From the Department of Anesthesia, Faculty of Medicine, Clinical Hospital of the University of Chile, Santiago, Chile.

A&A Practice
|June 13, 2018
PubMed

Insights

Decompressive craniectomy after middle cerebral artery stroke can be safely performed early, even within 6 hours of thrombolytic therapy. This case study demonstrates successful management of bleeding risks and improved patient outcomes.

Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Decompressive craniectomy (DC) is a crucial intervention for managing elevated intracranial pressure following severe stroke.
  • Standard practice typically delays DC for at least 24 hours after thrombolytic therapy due to concerns about hemorrhagic complications.
  • Early DC in conjunction with thrombolysis presents a therapeutic challenge balancing stroke management and bleeding risks.

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