Malignant
cerebral infarction has a high
risk of fatal
brain edema and increased
intracranial pressure with cerebral herniation causing
death. One of the major
causes of death is a rebound
cerebral edema during
rewarming phase. A 66-year-old
male patient presented with the right
hemiplegia and
global aphasia due to malignant
cerebral infarction in the whole territory of
middle cerebral artery with the occlusion of the proximal
internal carotid artery. Being refused decompressive hemicraniectomy, he received the
therapeutic hypothermia for 6 days. After
rewarming for 6 hours, mentality was suddenly decreased and dilated left
pupil. Follow-up CT revealed that midline shifting was more aggravated. We decided on repeated
hypothermia for rebound
cerebral edema and successfully controlled. We
report our experience with repeated
hypothermia for rebound
cerebral edema following
therapeutic hypothermia in malignant
cerebral infarction.