Precision management of brain oedema after acute ischaemic stroke.

Stroke is a leading cause of death and disability in the world, with acute ischaemic stroke accounting for ∼ 70% of all cases. 1 Some degree of brain oedema occurs in all cases of acute ischaemic stroke and, when severe, has major consequences on survival-free of disability. Pathophysiological studies indicate an evolu-tion of cytotoxic oedema, ionic oedema, and vasogenic oedema, 2 which implies brain oedema is a dynamic process and explains the various terminology used, such as large hemispheric infarc-tion,symptomatic infarct swelling,space-occupying infarction,or malignant middle cerebral artery (MCA) infarction . Heterogene-ity in manifestations and sequelae necessitates a new, precision medicine approach to individualizing prevention and treatment of brain oedema after stroke.