Brain edema following ischemic stroke often results in significant morbidity and death. Decompressive craniotomy has been advocated and may result in a surprisingly satisfactory outcome. We present a 17-year-old patient who developed a right middle cerebral artery territory infarction associated with a cardiac myxoma. Five days after the ictus and two days after a thoracotomy to remove the obstructing tumor, he developed clinical signs of uncal herniation. CT scans showed massive cerebral edema and development of obstructive hydrocephalus. An intracranial pressure monitor measured 30 mmHg on insertion. Management with mannitol reversed the clinical and radiologic signs of uncal herniation. There is a renewed interest in decompressive craniotomy. Our patient indicates that conventional management of increased intracranial pressure may reverse brain edema when associated with hemispheric infarction. Decompressive craniotomy needs validation in a randomized trial.

Keywords:
Intracranial pressure, Brain edema, Stroke
This content is only available via PDF.
© 1997 S. Karger AG, Basel
1997
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.