Stroke remains a major source of morbidity and mortality throughout the world representing the third leading cause of death in North America and the second leading cause of death in Asia . Large hemispheric strokes account for a majority of these deaths and represent a significant proportion of stroke patients treated in an intensive care unit (ICU). Our understanding of the secondary processes that occur after the initial stroke has changed our approach to the management of this population. We will review and discuss the new management strategies that have been developed to decrease the morbidity and mortality of patients with large hemispheric infarctions.
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