Symptoms of malignant edema after MCA stroke
What is the clinical presentation of malignant edema after MCA stroke?
The most common findings are hemiplegia, global or expressive aphasia, severe dysarthria, neglect, gaze preference, and a visual field defect.
Pupillary abnormalities are a reflection of significant brain stem shift, typically not expected on initial presentation, and develop within the first 3 to 5 days.
The initial National Institutes of Health Stroke Scale score is often >20 with dominant hemispheric infarction and >15 with nondominant hemispheric infarction, which is a reflection of stroke severity and infarct volume, not a marker of tissue swelling.
