Imaging Findings Associated with Space-Occupying Edema in Patients with Large Middle Cerebral Artery Infarcts.

AJNR. American Journal of Neuroradiology
Alexander D HorschDUST investigators

Abstract

Prominent space-occupying cerebral edema is a devastating complication occurring in some but not all patients with large MCA infarcts. It is unclear why differences in the extent of edema exist. Better knowledge of factors related to prominent edema formation could aid treatment strategies. This study aimed to identify variables associated with the development of prominent edema in patients with large MCA infarcts. From the Dutch Acute Stroke Study (DUST), 137 patients were selected with large MCA infarcts on follow-up NCCT (3 ± 2 days after stroke onset), defined as ASPECTS ≤4. Prominent edema was defined as a midline shift of ≥5 mm on follow-up. Admission patient and treatment characteristics were collected. Admission CT parameters used were ASPECTS on NCCT and CBV and MTT maps, and occlusion site, clot burden, and collaterals on CTA. Permeability on admission CTP, and day 3 recanalization and reperfusion statuses were obtained if available. Unadjusted and adjusted (age and NIHSS) odds ratios were calculated for all variables in relation to prominent edema. Prominent edema developed in 51 patients (37%). Adjusted odds ratios for prominent edema were higher with lower ASPECTS on NCCT (adjusted odds ratio, 1.32; 95% CI, 1.13-1....Continue Reading

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Citations

Jan 14, 2017·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Wolfgang G KunzKolja M Thierfelder
Jul 9, 2017·Stroke; a Journal of Cerebral Circulation·Matthias P FabritiusWolfgang G Kunz
Mar 11, 2018·Stroke; a Journal of Cerebral Circulation·Paul ReidlerWolfgang G Kunz
May 17, 2019·Stroke; a Journal of Cerebral Circulation·Frans KauwUNKNOWN DUST (Dutch Acute Stroke Study) investigators are as follows
Feb 25, 2019·Journal of Neurointerventional Surgery·Xianjun HuangZhiming Zhou
Oct 22, 2019·Journal of the American Heart Association·Matthias P FabritiusWolfgang G Kunz
Dec 11, 2019·Stroke; a Journal of Cerebral Circulation·Magnus ThorénNiaz Ahmed
Feb 3, 2019·Clinical Neuroradiology·Matthias F FroelichWolfgang G Kunz
Jan 29, 2019·Frontiers in Neurology·Lars-Peder PallesenVolker Puetz
Mar 20, 2021·AJNR. American Journal of Neuroradiology·H XiaW Chen
Mar 17, 2021·International Journal of Stroke : Official Journal of the International Stroke Society·Marie Louise E BernsenJeannette Hofmeijer
Jun 25, 2021·Frontiers in Neurology·Matthias BechsteinGabriel Broocks

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