Letter to the editor Decompressive craniectomy for stroke after intravenous thrombolytic therapy Dear editor, Decompressive craniectomy (DC) is a major surgical procedure that can save life of patients with malignant edema after middle cerebral artery (MCA) infarction (1). Intravenous thrombolysis (IVT) is the only approved treatment for patients with acute ischemic stroke within 4·5 hours of symptoms onset (2). Rare previously case studies have already stated that DC in the context of post-IVT treatment might be safe (3,4). We have an additional five cases in which early DC (