Some @entity64 @entity1 suffering acute @entity2500 develop massive @entity2657 and @entity3976 , a condition known as @entity2500 . Severe swelling @entity428 ( @entity428 ) and leads to progressive @entity409 . Once @entity428 reaches critical values (>30 mm Hg) @entity3976 occurs, usually within 2 to 5 days. @entity1 rarely survive (80% mortality) with standard treatment, and those who do are often severely disabled. @entity2500 is often missed by neurologists, despite well-defined clinical and neuroimaging (CT scan) diagnostic criteria. After diagnosis, conventional treatments such as osmotherapy, barbiturates, buffers, and hyperventilation center on reducing @entity428 . The goal of hyperosmolar therapy is to increase the serum osmolarity to approximately 315-320 mOsm/L. Enteric @entity653 is used routinely to reduce @entity428 . In more severe cases and when @entity653 fails, @entity2656 may be administered. Other therapies are also available, including hypertonic saline solution, THAM ( @entity8973 ) buffer, and high-dose barbiturates. Hyperventilation also helps reduce @entity428 . All measures work effectively for a short time only. Other approaches to control @entity428 , including decompression surgery and @entity2332 , have shown promising results. In the Heidelberg decompression surgery trial, mortality in surgically treated @entity1 was significantly lower (32%) than in non-treated @entity1 (76%) despite conventional treatment. Importantly, of the surviving treated @entity1 , 66% were rated independent with only mild to moderate disability. Moderate @entity2332 (33-36 degrees C) has recently been shown to be effective in severe @entity2500 . @entity2332 induction within 14 hours of @entity63 and maintained for 72 hours significantly reduced @entity428 and mortality (44%).

Treatment options for large hemispheric XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2656 :: ('MESH:D008353', 'Chemical') :: ['mannitol'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity2657 :: ('MESH:D001929', 'Disease') :: ['brain edema'] @entity3976 :: ('MESH:D004677', 'Disease') :: ['herniation'] @entity428 :: ('MESH:D019586', 'Disease') :: ['increases intracranial pressure', 'ICP', 'elevated ICP'] @entity2500 :: ('MESH:D020244', 'Disease') :: ['malignant MCA infarction', 'MCA infarction', 'Malignant MCA infarction', 'middle cerebral artery (MCA) infarction'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic injury'] @entity409 :: ('MESH:D008107', 'Disease') :: ['brainstem dysfunction'] @entity653 :: ('MESH:D005990', 'Chemical') :: ['glycerol'] @entity8973 :: ('MESH:D014325', 'Chemical') :: ['Tris-hydroxy-methyl-aminomethane'] @entity2332 :: ('MESH:D007035', 'Disease') :: ['hypothermia', 'Hypothermia']
@entity64 :: (MESH:D020521,Disease) :: ['stroke']
