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Chapter 36 - Space-occupying supratentorial and infratentorial ischemic stroke

from Section 2 - Vascular topographic syndromes

Published online by Cambridge University Press:  05 August 2012

By
Julian Bösel ,
Stefan Schwab  and
Rainer Kollmar
Edited by
Louis R. Caplan  and
Jan van Gijn
Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Center, Boston
Jan van Gijn
Affiliation:
University Medical Center, Utrecht
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Summary

Severe ischemic stroke with progressive edema development is frequently life-threatening and associated with a poor prognosis due to limited expandability within the cranial cavity. This chapter describes the relevant aspects of supra- and infratentorial space-occupying strokes with particular emphasis on the role of decompressive surgery. Large ischemic infarction of the middle cerebral artery (MCA) territory can lead to a clinical syndrome called malignant MCA stroke. Cranial computed tomography (CT) is still the most widely used radiological modality to diagnose and monitor malignant MCA infarction. The only specific treatment option for this type of stroke with a solid base of evidence and major impact on the clinical course to date is decompressive surgery, that is, hemicraniectomy. Swelling of a large space-occupying cerebellar infarct appears within a few days from symptom onset and can lead to compression of the brainstem and midbrain or cause a hydrocephalus.

Keywords

medulla oblongataponsposterior inferior cerebellar arteryleptomeningeal arteriesarterial territoriesbrainstem
Type
Chapter
Information
Stroke Syndromes, 3ed , pp. 419 - 425
Publisher: Cambridge University Press
Print publication year: 2012

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