PMC3806694_01
a Enhanced chest CT scan on admission shows pericardial effusion. MR angiography shows the occlusion of the superior division of the left M2 segment of the MCA (b) and diffusion-weighted MR imaging shows high signal intensity in the MCA territory (c). d Postoperative CT scan shows diffuse brain edema after the hemispheric infarction; decompressive craniectomy was performed.
crn-0005-0175-g01.jpg
PMC3806694_01_crn-0005-0175-g01.jpg
F1
Pericardial effusion and a collapsed inferior vena cava were revealed in heart echocardiograph and chest computed tomography (CT) examinations (fig. 1a). Diffusion-weighted MR imaging revealed high signal intensity in the MCA territory (fig. 1b, c), suggesting acute cerebral infarction. Due to the midline shift of the head on CT after 20 h of hospitalization, external and internal decompression surgery was performed (fig. 1d).
Summary of the fluid resuscitation of the patient after admission to the intensive care unit within 24 h. The lines depict the changes in hemoglobin and heart rate.
crn-0005-0175-g02.jpg
PMC3806694_01_crn-0005-0175-g02.jpg
F2
Mechanical ventilation and massive fluid resuscitation (10 liters/day) were implemented on the first day (fig. 2).
Photograph after bilateral calf fasciotomy (a) and intraoperative photograph after left forearm fasciotomy and carpal tunnel release (b).
crn-0005-0175-g03.jpg
PMC3806694_01_crn-0005-0175-g03.jpg
F3
Pretibial compartment syndrome was diagnosed and bilateral calf fasciotomy was performed (fig. 3a). Despite compliance with the prescribed medications, 7 attacks of ISCLS were documented during the first 12-month follow-up, with 2 severe episodes requiring fasciotomy (fig. 3b).