MCA infarct and decompressive craniectomy

Case contributed by Frank Gaillard

Presentation

Acute onset left sided weakness.

Patient Data

Age: 50 years
Gender: Male

CTB - Day 0

ct

Long segment of hyperdense right MCA artery in keeping with thromboembolism. The grey white matter differentiation of the insular cortex is lost. No convincing other features of infarction. 

CTB - Day 3

ct

Large patchy MCA and ACA territory infarct with marked midline shift. 

CTB - Day 5

ct

Decompressive craniectomy has been performed.  

CTB - Day 11

ct

Swelling starting to subside. 

Case Discussion

Decompressive craniectomy can be effective in preventing swelling induced morbidity and mortality if done early enough. 

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