Abstract
The term malignant middle cerebral artery syndrome (MMCAS) describes the space occupying swelling that follows a large MCA territory infarct. Severe brain swelling causes midline shift, elevation in intracranial pressure (ICP) and brain herniation, and carries a mortality rate of up to 80 %.
Here we discuss an exemplary case of right MMCAS due to embolic phenomenon. Initially treatment was thrombolysis, however in less than 24 hours the patient neurologically deteriorated, requiring decompressive hemicraniectomy (DHC).
DHC is an emergency neurosurgical procedure and requires expedient management as delay adversely affects outcome. Current management guidelines are reviewed and a clinical algorithm to guide decision-making is presented.
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© 2015 Springer-Verlag London
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Wykes, V., Epstein, D., Grieve, J.P. (2015). A Potentially Fatal Complication. In: Gill, S., Brown, M., Robertson, F., Losseff, N. (eds) Stroke Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6705-1_12
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DOI: https://doi.org/10.1007/978-1-4471-6705-1_12
Publisher Name: Springer, London
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