الفهرس 
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Abstract
Ischemic stroke is an acute brain injury occurs as a result of an obstruction of a blood vessel supplying a part of the brain. [Adams, et al; 2010]
The most common causes for ischemic stroke is thrombosis that may be due to vessel wall diseases or blood diseases causing hyperviscosity or circulation diseases causing slow circulation or embolism [the sourse may be the heart or distal vessel]. [Chang & Bendixen; 2011]
The commonest risk factors are hypertension, diabetes mellitus, smoking, high cholesterol level, coronary artery disease, coronary artery bypass, or atrial fibrillation. [Mozaffarian, et al; 2015]
Signs and symptoms of stroke include sudden onset of Hemiparesis , monoparesis , or quadriparesis, Hemisensory deficits, Monocular, binocular visual loss, Visual field deficit, dysarthrias, facial droop, ataxia, vertigo or aphasia. [Dirnagl, et al; 2011]
Noncontrast CT scanning is the most commonly used form of neuroimaging to diagnos stroke. The following neuroimaging techniques may also be used: CT angiography, CT perfusion scanning, brain MRI, carotid duplex scanning, echocardiography and full lap investigations. [Mullins & Lev, 2013]
Acute massive MC and massive cerebellar infarctions may cause massive brain swelling that may be medically uncontrolled, known as malignant infarction and severe post-ischemic brain edema leading to raised intracranial pressure (ICP), brain herniation, clinical deterioration, coma and death despite aggressive conservative treatment so surgery may be required. [Carter, et al; 2010]
Decompresive craniectomy is used to relieve raised ICP in massive MCA infarction and massive cerebellar infarction. [Walz, et al; 2011]
Decompresive craniectomy can be done in patients with massive MCA infarction with progressive deterioration in the conscious level or massive cerebellar infarction compressing the brain stem and causing progressive deterioration in the conscious level despite conservative treatment and produce good results. [Bettin & Koster; 2012]