A 48-year-old man has a large right middle cerebral artery infarction despite reperfusion treatment. Twenty-four hours later he becomes increasingly drowsy, develops a left hemiparesis and has a right dilated sluggish pupil. Repeat CT shows extensive hemispheric swelling with 8 mm of midline shift and early compression of the lateral ventricle. Which one of the following is the most appropriate definitive treatment?
Keep going — a set of ten like this one, one at a time.
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