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Hemispheric strokes: clinical or surgical management? Intracranial pressure monitoring of a case and review of the literature.

The authors report a case of a right hemispheric ischemic infarction on a 77-year-old patient that was monitored with an extradural intracranial pressure monitor (Ladd device). We show the huge intracranial hypertension that the brain was submitted despite of the medical treatment. The treatment of hemispheric strokes can be very challenging. The usual antiedema drugs very often prove to be of no help against the mass effect and the high intracranial pressure that some patients present. More recently reports on the literature are showing good results following a decompressive surgery on such ischemic infarcts.