Category: Critical Care
Keywords: large hemispheric infarct, acute ischemic infarct, stroke (PubMed Search)
Updates in the Management of Large Hemispheric Infarction
Large hemispheric infarctions (LHI) are estimated to occur in 2-8% of all hospitalized ischemic strokes and 10 15% of all MCA territory infarcts. LHI carry high rates of morbidity and mortality, in fact, if left untreated associated cerebral edema can rapidly progress to transtentorial herniation and death in 40 80% of patients.
Recognized risk factors for progressive cerebral edema include:
Evidence based medical strategies for LHI include:
Bottom Line: Early recognition of large hemispheric stroke is critical as it is associated with a high rate of morbidity and mortality. Aggressive medical management and early neurosurgical involvement may improve outcomes.
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