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1. Introduction
2. Introductory remarks
3. The deteriorating IS - content
4. Causes of early deterioration after IS (1)
5. Causes of early deterioration after IS (2)
6. Causes of early deterioration after IS (3)
7. Pathophysiology of ischemic brain edema
8. Edema formation after ischemic stroke
9. Treatment of brain edema
10. Pathophysiology of space occupying infarction (1)
11. Pathophysiology of space occupying infarction (2)
12. Delay of edema-formation and ICP-elevation
13. Malignant MCA infarction
14. Early neurologic death after stroke (1)
15. Complete MCA-infarction imaging
16. Herniation imaging
17. Early neurologic death after stroke (2)
18. Clinical course
19. Early diagnosis of malignant MCA infarction
20. Early infarct signs
21. Natural history and early diagnosis
22. Malignant MCA and brain edema
23. ICU care for ischemic stroke
24. Baseline therapy in severe stroke
25. ICP-therapy in stroke (1)
26. Medical therapy
27. ICP-therapy in stroke (2)
28. Hypothermia
29. Hypothermia - trauma and cardiac arrest
30. How to cool the brain?
31. Hypothermia side effects
32. Hypothermia - influence on edema formation
33. ICP-therapy in stroke (3)
34. Decompressive surgery - technical aspects
35. Peri-operative ICU treatment
36. Results of decompressive surgery
37. History of decompressive surgery
38. The prospective cohort series (1)
39. The prospective cohort series (2)
40. Meta-analyses and registries
41. The controversy - predictors of outcome
42. The controversy - survival vs. quality of life
43. The reality of randomized trials for rare conditions
44. The 5 randomized clinical trials (1)
45. The 5 randomized clinical trials (2)
46. The pooled analysis - DESIRE
47. Design of the pooled analysis (1)
48. Design of the pooled analysis (2)
49. Design of the pooled analysis (3)
50. Results - distribution of outcome
51. Results - primary endpoint
52. Conclusions
53. Open questions (1)
54. Timing of decompressive surgery
55. Timing (1)
56. Timing (2)
57. Open questions (2)
58. DESIRE- pooled analysis
59. Do we need more evidence from further RCTs?

Topics Covered

• Causes of stroke
• Pathophysiology of ischemic brain edema
• Space occupying infarction
• Treatment of ischemic brain edema
• Causes of early deterioration after ischemic stroke
• Large, space occupying edema
• Edema formation after ischemic stroke
• Treatment of brain edema
• Pathophysiology of space occupying infarction
• Delay between edema formation and ICP-elevation
• Malignant MCA infarction
• Clinical course
• Natural history and early diagnosis
• Malignant MCA and brain edema
• Conservative treatment options
• ICU care for ischemic stroke
• Baseline therapy in severe stroke
• ICP therapy in stroke
• Medical therapy
• Hypothermia
• Decompressive surgery
• The controversy: survival vs. quality of life
• The reality of randomized trials for rare conditions
• The 5 RCTs
• Pooled analysis design
• Results
• Timing
• The need for more evidence for the general approach and not the details

Links

Series:

• Cerebrovascular Disease

Categories:

• Clinical Practice
• Neuroscience

Therapeutic Areas:

• Neurology

Talk Citation

Publication History

• Published on October 27, 2008
• Archived on June 22, 2016

Financial Disclosures

• Prof. Werner Hacke has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.