Fulminant cerebral edema in the setting of acute dengue fever after mechanical thrombectomy in a patient with massive stroke and severe hypoalbuminemia: a case report

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A 61-year-old man with significant hypoalbuminemia experienced rapid cerebral edema following mechanical thrombectomy for a large vessel occlusion stroke.
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Acute dengue fever and bacterial pneumonia were identified post-thrombectomy, contributing to systemic inflammatory response and worsening neurological status.
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Cerebral edema escalated rapidly, with midline shift increasing from 4 mm to 11 mm, indicating malignant edema and risk of brain herniation.
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The case highlights the interplay of systemic inflammatory stressors and blood-brain barrier susceptibility in post-reperfusion cerebral edema.
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The patient's family declined further intervention, leading to discharge against medical advice and subsequent death during follow-up.

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