A 50-year-old man on ICU following a large right MCA territory infarction develops uncal herniation with a new left-sided fixed dilated pupil. CT show...

Question

A 50-year-old man on ICU following a large right MCA territory infarction develops uncal herniation with a new left-sided fixed dilated pupil. CT shows significant midline shift (12 mm). ICP is 40 mmHg. What is the most appropriate emergency neurosurgical intervention?

Accepted Answer

Decompressive hemicraniectomy

Answer

Burr hole drainage

Answer

VP shunt insertion

Answer

ICP bolt insertion and medical management only

Answer

Lumbar puncture

uk-fficm MCQ (SBA): Malignant MCA Infarction

A 50-year-old man on ICU following a large right MCA territory infarction develops uncal herniation with a new left-sided fixed dilated pupil. CT shows significant midline shift (12 mm). ICP is 40 mmHg. What is the most appropriate emergency neurosurgical intervention?