Treatment of malignant brain edema and increased intracranial pressure after stroke.
The management of patients with large territory ischemic strokes and the subsequent development of malignant brain edema and increased intracranial pressure is a significant challenge in modern neurology and neurocritical care. These patients are at high risk of subsequent neurologic decline and are best cared for in an intensive care unit or a comprehensive stroke center with access to neurosurgical support. Risks include hemorrhagic conversion, herniation, poor functional outcome, and death. This review discusses recent advances in understanding the pathophysiology of edema formation, identifying patients at risk, current management strategies, and emerging therapies.
Neurological Intensive Care Unit, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Ave H/22, Cleveland, OH, 44139, USA.
Michael E
ME
Brogan
Edward M
EM
Manno