How do you approach the management of a large vessel stroke if you anticipate the development of malignant cerebral edema?

Topics: Neurology • Neuro-critical care

Is there any benefit to starting hyperosmolar therapy prior to the development of depressed level of consciousness or midline shift?

Answer from: at Academic Institution

In ischemic strokes with anticipated malignant cerebral edema, I would base some initial management decisions for prevention of edema on the labs obtained at admission. If the sodium is less than 130, I would start hyperosmolar therapy to bring levels into a normal range. If less than 135, normal sa...

Comments

at LAC+USC Medical Center - Los Angeles
Thank you so much, this is very helpful!

at Novant Health
Even though there are no records for preventive tr...

at Aurora St. Luke's Medical Center
I would caution being comfortable after 24 hours g...

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