Mild hypothermia in combination with hemicraniectomy is superior to hemicraniectomy alone in patients with severe ischemic stroke

We compared the clinical outcome of 45 consecutive patients with a malignant supratentorial infarction. 35 patients were treated with hemicraniectomy alone (H) after diagnosing ischemic infarction of more than two third of the hemisphere by diffusion-weighted imaging without signs of cerebral herniation or brainstem syndrome.10 patients received a combination therapy with hypothermia (35° C) and hemicraniectomy (HH). Hypothermia was induced within 12±4hours (mean±SD) after stroke by a intravenous (n=8) or a external cooling device. Hemicraniectomy was performed within 18±9hours after the ischemic event. Age, cra…