Brain imaging findings before and after hemicraniectomy in malignant MCA infarction

(A) Axial cranial CT seven hours after stroke onset. Arrows indicate the margins of the infarction.
(B) Axial diffusion-weighted MRI in the acute phase of malignant MCA infarction.
(C) and (D) Axial CT on day two after symptom onset after hemicraniectomy. Note that despite decompressive surgery, a compression of the ventricular system with slight midline shifting (C; axial CT at the level of the basal ganglia) and a beginning outward swelling (D; axial CT at the supraventricular level) of the ischemic brain tissue is evident.