{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T01:22:36Z","timestamp":1771636956662,"version":"3.50.1"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nSubacute subdural hematomas (ASDH) are only treated surgically when they cause mass effect significant enough to give symptoms. Rarely, sub-ASDH may cause enough pressure to result in a malignant middle cerebral artery (MCA) territory infarction. Decompressive craniectomy (DC) is the last resort to reduce intracranial pressure following malignant MCA infarction. Herein, we review the literature and describe a case of MCA\/posterior cerebral artery (PCA) territories infarction following drainage of a sub-ASDH that was treated with DC with good outcome.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nWe report a case of malignant right-sided MCA\/PCA infarction in a 62-year-old man who presented with progressive headache following a cycling incident leading to a head injury. Initial CT head demonstrated a small right ASDH. He had no neurological deficit, headache settled on analgesia, and there was no expansion of the SDH on the repeat CT; therefore, he was managed conservatively. He was admitted 6-days later with worsening headaches and hyponatremia. Repeat CT revealed an increase in size of the hematoma and mass effect leading to a mini-craniotomy and evacuation of hematoma. He developed left-sided hemiplegia, slurred speech and hyponatremia, and CT head demonstrated a right-sided MCA\/PCA infarction with significant mass effect. He underwent emergent DC and subsequent cranioplasty and ultimately recovered to mRS of 2.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nSDH are frequent neurosurgical entities. Malignant MCA\/PCA strokes following mini-craniotomies are rare but need to be considered especially during the consent process.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_838_2020","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T19:43:28Z","timestamp":1615923808000},"page":"105","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Malignant middle cerebral artery infarction following subacute subdural hematoma: A case report and literature review"],"prefix":"10.25259","volume":"12","author":[{"given":"Saad","family":"Moughal","sequence":"first","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, London, United Kingdom,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micaela","family":"Uberti","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences 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