Predictors of malignant brain edema after mechanical thrombectomy for acute ischemic stroke

Journal of Neurointerventional Surgery
Xianjun HuangZhiming Zhou

Abstract

Malignant brain edema (MBE) is a devastating complication in ischemic stroke. Data on MBE in patients who have had mechanical thrombectomy (MT) are relatively scarce. To investigate the incidence, predictors, and clinical outcomes of MBE in patients after MT. We included 130 consecutive patients after MT caused by anterior circulation large vessel occlusion stroke, treated with MT. MBE was defined as a midline shift of ≥5 mm on the follow-up imaging within 72 hours after MT. Characteristics of patients at admission and details of treatment were collected. The 90-day modified Rankin scale score was used as a measure of functional outcomes. Of the 130 patients (age, 68.6±10.9 years; male, 50%), 35 (26.9%) patients developed MBE. The patients with MBE had a lower rate of functional independence (OR=7.831; 95% CI 1.731 to 35.427; p=0.008) and significantly higher mortality at 90 days (OR=7.958; 95% CI 2.274 to 27.848; p=0.001) than patients without MBE. In 104 (80%) patients with successful recanalization (modified Thrombolysis in Cerebral Infarction score of 2b-3), 24 (23.1%) patients exhibited MBE. After adjustment for confounding, ICA occlusion (OR=3.746; 95% CI 1.169 to 12.006; p=0.026) and worse collateral score (grade 1 vs gr...Continue Reading

References

Oct 27, 1997·Neurology·P M PullicinoJ W Norris
Nov 26, 2002·Annals of Neurology·Chelsea S KidwellJeffry R Alger
Jul 26, 2003·Stroke; a Journal of Cerebral Circulation·David S Liebeskind
Feb 17, 2007·Lancet Neurology·Katayoun VahediUNKNOWN DECIMAL, DESTINY, and HAMLET investigators
Jul 30, 2011·Stroke; a Journal of Cerebral Circulation·José M FerroUNKNOWN Second International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT 2) Investigators
Mar 13, 2012·International Journal of Stroke : Official Journal of the International Stroke Society·Daniel StrbianUNKNOWN Helsinki Stroke Thrombolysis Registry Group
Jul 11, 2013·Neurocritical Care·Brian P WalcottKevin N Sheth
Jan 16, 2014·Journal of the Neurological Sciences·Takashi ShimoyamaYasuyuki Iguchi
Dec 17, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Hoon KimKwang Wook Jo
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Jun 11, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Jan 23, 2016·AJNR. American Journal of Neuroradiology·A D HorschUNKNOWN DUST investigators
Jul 22, 2017·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Hannah J IrvineW Taylor Kimberly
Aug 5, 2017·Stroke; a Journal of Cerebral Circulation·Magnus ThorénNiaz Ahmed
Aug 12, 2017·Journal of Neurointerventional Surgery·Alessandro DavoliFabrizio Sallustio
Jan 25, 2018·The New England Journal of Medicine·Gregory W AlbersUNKNOWN DEFUSE 3 Investigators
May 10, 2018·Journal of Neurointerventional Surgery·Vanessa ChalumeauMikael Mazighi
Oct 21, 2018·World Neurosurgery·Guilherme Santos PiedadeChristoph J Griessenauer
Oct 26, 2018·Stroke; a Journal of Cerebral Circulation·Ashutosh P JadhavTudor G Jovin
Dec 21, 2018·Stroke; a Journal of Cerebral Circulation·Simiao WuMing Liu

❮ Previous
Next ❯

Citations

Dec 11, 2019·Stroke; a Journal of Cerebral Circulation·Magnus ThorénNiaz Ahmed
Mar 31, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Ehsan DowlatiDaniel R Felbaum
Mar 30, 2021·Frontiers in Cell and Developmental Biology·Ming-Shu XuChun-Lei Shan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.