Managing Malignant Cerebral Infarction
- 29 December 2010
- journal article
- critical care-neurology
- Published by Springer Science and Business Media LLC in Current Treatment Options in Neurology
- Vol. 13 (2), 217-229
- https://doi.org/10.1007/s11940-010-0110-9
Abstract
Managing patients with malignant cerebral infarction remains one of the foremost challenges in medicine. These patients are at high risk for progressive neurologic deterioration and death due to malignant cerebral edema, and they are best cared for in the intensive care unit of a comprehensive stroke center. Careful initial assessment of neurologic function and of findings on MRI, coupled with frequent reassessment of clinical and radiologic findings using CT or MRI are mandatory to promote the prompt initiation of treatments that will ensure the best outcome in these patients. Significant deterioration in either neurologic function or radiologic findings or both demand timely treatment using the best medical management, which may include osmotherapy (mannitol or hypertonic saline), endotracheal intubation, and mechanical ventilation. Under appropriate circumstances, decompressive craniectomy may be warranted to improve outcome or to prevent death.Keywords
This publication has 50 references indexed in Scilit:
- Glibenclamide Is Superior to Decompressive Craniectomy in a Rat Model of Malignant StrokeStroke, 2010
- Decompressive craniectomy for massive cerebral infarction with enlarged cruciate duraplastyActa Neurochirurgica, 2007
- Guidelines for the Early Management of Adults With Ischemic StrokeStroke, 2007
- Surgical Management of Massive Cerebral InfarctionJournal of Korean Neurosurgical Society, 2007
- Factors affecting the outcome of decompressive craniectomy for large hemispheric infarctions: a prospective cohort studyActa Neurochirurgica, 2005
- Early external decompressive craniectomy with duroplasty improves functional recovery in patients with massive hemispheric embolic infarction: Timing and indication of decompressive surgery for malignant cerebral infarctionSurgical Neurology, 2004
- Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trialJournal of Neurosurgery, 2004
- Sonographic Monitoring of Midline Shift in Space-Occupying StrokeStroke, 2001
- Prediction of Malignant Middle Cerebral Artery Infarction by Diffusion-Weighted ImagingStroke, 2000
- Hypertonic Saline Worsens Infarct Volume After Transient Focal Ischemia in RatsStroke, 2000