Cerebral edema in stroke

Brain edema causes herniation and death in many patients with large cerebral infarctions. Evidence suggests that even small infarcts may result in edema that contributes to further ischemia. Thus, ischemic cerebral edema appears to contribute heavily to morbidity and mortality in stroke. Normotension and normothermia should be carefully maintained, as should adequate ventilation and oxygenation. These measures are the most important and the most easily neglected. Various drugs in current use are of limited value in ischemic brain edema, but several new treatments of potential value are being explored.