[Effectiveness of Decompressive Craniectomy for Severe Cerebral Infarction Caused by Stanford Type A Acute Aortic...

The optimal surgical management of Stanford type A acute aortic dissection complicated by severe cerebral infarction remains controversial. We present a case of a 48-year-old man with Stanford type A acute aortic dissection complicated by malperfusion of the right common carotid artery. His consciousness was deteriorating preoperatively, and we performed an emergent aortic root replacement and partial aortic arch replacement. He suffered a severe cerebral edema with a brain herniation caused by cerebral infarction after the surgery. Decompressive craniectomy saved his life and improved his neurologic functions, and he has become able to communicate well. It is suggested that the decompressive craniectomy for the severe cerebral infarction after a surgery for type A acute aortic dissection with cerebral malperfusion is a good option for better neurologic outcomes.