Stroke - Malignant Middle Cerebral artery syndromeCreated by:
Malignant middle cerebral artery (MCA) syndrome can occur after middle cerebral artery stroke, with rapid neurological or conscious level deterioration, due to space occupying oedema. The symptoms that suggestive of malignannt middle cerebral artery infarction can be ranging from headache, vomiting, to rapid deterioration of consciousness level of Glascow Come Scale (GCS). Diagnosis will be support by radiology evidence of cerebral oedema , and mass effect. Its general prognosis is very poot, with high mortality (up to around 80%) and morbidity. The definite treatment option will be decompressive hemicraniectomy, by neurosurgical team. Pooled analysis from DECIMAL, DESTINY, and HAMLET trials showed mortaity benefit and favourable outcome, in surgery group. The reason behind decompressive hemicraniectomy is to relive the high intracranial pressure, allowing space for oedematous brain to expand. Anyone has experience in this area ?