The ideal candidates are younger patients with full MCA distribution stroke. One issue to be mindful of is that the “watch” part should be focused on watching to confirm the radiographic size of the stroke and the presence of cerebral edema. I would caution against watching for clinical ...

If the infarct is >2/3 of MCA territory and the patient is <60 years of age, they should be considered for decompressive hemi-craniectomy (DHC) within 48 hours of the ischemic event. This criterion is based on a meta-analysis of three RCTs of Destiny, Decimal, and Hamlet (Vahedi et al., PMID 1...