STROKE-MALIGNANT MCA INFARCTION
SUMMARY
1. Malignant middle cerebral artery (MCA) infarction is a life-threatening form of cerebrovascular accident where the area supplied by the MCA is completely infarcted.
2. It occurs in up to 10% of all stroke patients[1].
3. Patients suffering from malignant MCA infarction usually present clinically with severe hemispheric stroke syndrome including hemiplegia, forced eye and head deviation and progressive deterioration of consciousness within the first 2 days.
4. Symptoms of transtentorial herniation can then occur within 2 to 4 days after the onset of the stroke. This presentation is then followed by early CT signs of major infarcts during the first 12 hours after the stroke[2].
5. The prognosis is extremely poor and the mortality rate for patients who undergo conservative management can be as high as 80%[3].
6. The treatment of malignant MCA is targeted towards decreasing the ICP which is raised as a result of the infarction: conservative medical management vs. surgical decompression.
Reference(s)
- ↑ Moulin DE, Lo R, Chiang J, Barrett HJM. Prognosis in middle cerebral artery occlusion. Stroke. 1985. 16: 282 – 284.
- ↑ Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R. Malignant middle cerebral artery infarction: Clinical course and prognostic signs. Arch Neurol. 1996. 53: 309 – 315.
- ↑ Hacke W, Schwab S, Horn M, Spranger M, De Georgia M, von Kummer R. Malignant middle cerebral artery infarction: Clinical course and prognostic signs. Arch Neurol. 1996. 53: 309 – 315.
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Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].