Acute Decompressive Hemicraniectomy to Control High Intracranial Pressure in Patients with Malignant MCA Ischemic Strokes.

Malignant middle cerebral artery (MCA) infarction occurs in about 10% of all patients with supratentorial ischemic strokes. The infarction involves the entire MCA territory. Due to the consequences of severe brain edema, brain herniation, elevated intracranial pressure (ICP), and midline shift, these events carry a mortality rate of up to 80%.

HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging.

Background And Purpose: Acute vestibular syndrome (AVS) is often due to vestibular neuritis but can result from vertebrobasilar strokes. Misdiagnosis of posterior fossa infarcts in emergency care settings is frequent. Bedside oculomotor findings may reliably identify stroke in AVS, but prospective studies have been lacking.

Treatment of intracerebral hemorrhage: what should we do now?

Intracerebral hemorrhage (ICH) is the most lethal type of stroke. Level I, class A evidence of effective treatment is lacking. Many issues surrounding the optimal management of ICH, such as blood pressure control, prevention of hematoma growth, containing brain edema, and preserving cerebral perfusion, need more rigorous clinical research.