Brain oedema after major ischaemic infarction is a life-threatening complication for which no preventive therapy exists. Decompressive hemicraniectomy can be lifesaving and improve functional outcomes, particularly in young patients (aged <60 years).1 Osmotic agents might have some therapeutic utility, particularly as a bridge to surgery.2 Yet, despite these treatments, death or major disability are typical outcomes. Endovascular therapy improves functional outcomes in selected patients with large vessel occlusion who also have a large ischaemic core.