Decompressive hemicraniectomy followed by subsequent
therapeutic hypothermia can reduce
mortality in
patients with malignant
cerebral infarction without significantly increasing
risk. We
report three cases of malignant
cerebral infarction treated with hemicraniectomy followed by
hypothermia. Case 1 received elective decompressive
surgery and
hypothermia. Case 2 developed subsequent
cerebral infarction with uncal herniation. Therefore, emergent decompressive
surgery and
hypothermia was performed in this case. Despite
surgery and hyperosmolar
therapy, case 3 received
hypothermia treatment for refractory increased
intracranial pressure. All
patients survived with a score of 4 or 5 on the modified Rankin scale. Therefore, we suggest that application of
hypothermia after hemicraniectomy is safe and feasible. Several possible modifications can be made to improve the management strategy in order to increase the benefits of
hypothermia treatment.