Objective:

To present a unique case of malignant cerebral edema following mechanical thrombectomy in a patient with acute dengue fever and significant hypoalbuminemia, highlighting its clinical implications.

Key Findings:

• The patient exhibited rapid deterioration of neurological function post-thrombectomy, with NIHSS scores worsening from 9 to 16.
• Significant hypoalbuminemia and systemic inflammatory response were present, with procalcitonin levels peaking at 1.18 ng/mL.
• Cerebral edema escalated rapidly, leading to a midline shift from 4 mm to 11 mm, indicative of malignant edema.

Interpretation:

The case suggests that acute cerebral edema may be influenced by blood-brain barrier susceptibility due to ischemia-reperfusion injury, exacerbated by systemic inflammatory stressors and significant hypoalbuminemia, which may lower tolerance to fluid shifts.

Limitations:

• The case is a single patient report, limiting generalizability and potential biases.
• Lack of detailed longitudinal data on the patient's condition post-discharge.

Conclusion:

The interplay of dengue infection, hypoalbuminemia, and post-thrombectomy edema highlights the need for vigilance in similar clinical scenarios, particularly in dengue-endemic regions, to improve patient outcomes.