Fig. 3

Case 1: favourable outcome GOS 5 41 years old female patient known hypertensive on medications, came to the Emergency department with acute onset right side body weakness, headache and dizziness, on arrival to the hospital she was conscious with sensory dysphasia, the initial CT brain A revealed left T/P acute ischemic stroke with lower trunk left MCA territory distribution without midline shift, admitted under observation, on the 3rd day of her admission her GCS dropped to GCS 10, an urgent CT brain B revealed evolutional change at the infarction core with midline shift of about 5 mm, underwent emergency surgical decompressive craniectomy and duroplasty that was performed within 5 h from the time of deterioration and the patient was sent to ICU, on the second postoperative day patient weaned from ventilator, GCS 14, FU CTA brain was done (C, D) and revealed nice decompression. On the third POD, patient improved more and discharged from ICU and FU CT brain revealed lax brain at both one, two weeks PO (E, F), then Cranioplasty was performed after 19 days from DC, and post-cranioplasty follow up CT brain (G, H) showed no adverse effects and satisfactory reconstruction