Management of massive hemispheric cerebral infarct: is there a ray of hope?

Abstract

Catastrophic infarcts of the cerebral hemisphere often involve occlusion of the middle cerebral artery. In approximately 50% of these patients, consciousness declines because of brain swelling. Management includes prevention of further systemic complications, and recent studies have suggested that decompressive hemicraniectomy or moderate hypothermia may improve outcome. Mortality may be decreased, but morbidity should be carefully evaluated in clinical trials before these interventions are accepted as standard.