Brain infarction is a frequent cause of emergency admission to hospital. We have made a retrospective study in order to describe patients who develop fatally elevated intracranial pressure. From 1991 to 1993, seven patients (3.3%) died within the first 96 hours after the symptoms appeared. All these patients died from elevated intracranial pressure caused by oedema in and around an infarction in the territory of the middle cerebral artery. These patients were significantly younger than the general population of patients with infarction (p < 0.01), and also younger than the patients who died from other causes during the observation period (p < 0.01). We think that these cases underline the importance of establishing effective acute treatment for ischemic cerebrovascular diseases, since this is probably the only effective way to protect against formation of oedema.