Decompressive Hemicraniectomy and Favorable Outcome in a Pediatric Patient with Malignant Middle Cerebral Artery Infarction

Figure 1

(a) : MRI brain WO contrast. An MRI of the brain showed an acute infarct without hemorrhage involving the left insula and territory of the left middle cerebral artery. (b) MRI brain W-WO contrast. There is a loss of appropriate signal intensity within the M1 segment of the left MCA for a length of appropriate 9 mm. There is a reconstitution of appropriate signal intensity distal to the aforementioned. There is diminutive signal intensity involving the supraclinoid aspect of the right ICA with appropriate reconstitution distally, which may be artifactual in nature as no restricted diffusion is seen within the right cerebral hemisphere. The parent branches, the ACAs, PCAs, basilar artery, and vertebral arteries appear without significant stenosis. (c) MRI angiogram with head WO contrast. There is a demonstration of restricted diffusion involving the left basal ganglia and portions of the left frontal, parietal, and temporal lobes.

(a)

(b)

(c)