Decompressive craniectomy for Rt. MCA stroke induced maligna | Figure 1

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Decompressive craniectomy for Rt. MCA stroke induced malignant edema

73-year-old male, hypertensive and diabetic with previous history of CVA. Admitted to neurology team with left-sided weakness and decreased level of consciousness. Brain CT on admission showed right MCA infarction. On 4th day of admission, the left-sided weakness worsened and the level of consciousness deteriorated. Urgent brain CT showed malignant edema with midline shift to the left. Upon encounter by the neurosurgical team, GCS was 8/15, bilateral pupils were distorted and nonreactive due to previous eye surgeries. Patient was intubated and underwent urgent decompressive craniectomy. 2cm midline shift in preop CT.

Diagnosis added by author

Malignant brain edema

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Brain CT showed diffuse edema in the left hemisphere and subarachnoid hemorrhage at the level of the left temporal lobe

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72-year-old female presents with left-sided weakness. Non-contrast CT head shows a 'dense middle cerebral artery' on the right with normal appearance of the left middle cerebral artery. This is consistent with a thrombus (blood clot)...

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64y/o M. Previous medical history of Arthritis. Presented with new onset Left sided Hemiplegia...

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48-hour difference after L MCA #Stroke. Note midline shift related to brain edema.

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patient in late teens presenting after a collapse, no chest pain, no previous cardiac history...