Clinical Features of a Large-Area Cerebral Infarction With Good Prognosis

Yi Bao, Yayong Ding, Quanying Liu, Cong Wu, Lingge Xu, Xiaodong Liu, Guangjian Liu


Large-area cerebral infarction has a high disability rate, and is a serious threat to patients’ lives. This article reports that a patient with a large-area cerebral infarction with a midline shift had recovered well after conservative treatment, and analyzes the reasons. We described the onset of the disease, the course of treatment, the evolution of the disease and response measures, combined with imaging to show the progress and changes of the disease. Although there was no thrombolysis, the blood vessels were recanalized. When the midline was displaced, although the bone flap was not removed to reduce the intracranial pressure, cerebral hernia was effectively prevented by dehydration treatment. The patient had severe loss of nerve function at the onset of the disease. After comprehensive treatment, good results have been achieved. Comprehensive treatment in stroke unit is helpful to save ischemic penumbra. Close monitoring of patients’ vital signs and mental changes is conducive to timely response to changes in the disease. Early rehabilitation is conducive to the recovery of neurological function. For the case of low thrombolytic acceptance rate, screening before thrombolysis, close observation during thrombolysis and timely reviewing after thrombolysis are adopted to actively respond to hemorrhage transformation after thrombolysis, which improve the safety and acceptability of treatment.

J Med Cases. 2019;10(5):141-145


Cerebral infarction; Digital subtraction angiography; Hemorrhage transformation; Thrombolysis; NIHSS score

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