Early computed tomography features in extensive middle cerebral artery territory infarct: prediction of survival

Lam, W. W. M.; Leung, T. W. H.; Chu, W. C. W.; Yeung, D. T. K.; Wong, L. K. S.; Poon, W. S.
March 2005
Journal of Neurology, Neurosurgery & Psychiatry;Mar2005, Vol. 76 Issue 3, p354
Academic Journal
journal article
Background: To assess the predictive value of prognosis of different computed tomography (CT) features and National Institutes of Health Stroke Scale score (NIHSS) in acute extensive middle cerebral artery (MCA) infarct. Methods: Fifty five patients with acute extensive MCA infarct had the CT performed within 24 hours of the onset of symptoms. A total of 11 CT features were analysed. The age distribution, presence of risk factors, presence of individual CT feature, the total CT score, and the NIHSS were correlated with the 30 day mortality. Results: Single explanatory variable analysis showed NIHSS, presence of midline shift, midline shift of more than 1 cm, extent of infarct, presence of hydrocephalus, effacement of subarachnoid space/cella media, attenuation of corticomedullary differentiation, and total CT score were associated with the 30 day mortality. Both extent of infarct >67% and attenuation of corticomedullary differentiation gave a sensitivity and specificity of 93% and 95%, respectively, for the prediction of survival. Logistic regression analysis showed that the extent of infarct and NIHSS were the only independent predictors. Conclusions: CT features and admission NIHSS are important parameters for prediction of survival in extensive MCA infarct.


Related Articles

  • Complex intracranial arterial anatomy in swine is unsuitable for cerebral infarction projects. Burbridge, Brent; Matte, Gilbert; Remedios, Audrey // Canadian Association of Radiologists Journal;Dec2004, Vol. 55 Issue 5, p326 

    The article focuses on the suitability of complex intracranial arterial anatomy in swine for cerebral infraction projects. Angiography is performed on an anesthetized pig. A right femoral artery cannulation was carried out, and angiographic images of the right cerebral arteries were obtained. It...

  • Improvement of Regional Cerebral Blood Flow After Stimulation of the Nucl. Fastigius in Cerebral Infarction Patients. Li, Q.; Yang, J. // Neurophysiology;Jun2015, Vol. 47 Issue 3, p234 

    Experimental studies reported that focal stimulation of the nucl. fastigius (fastigial nucleus stimulation, FNS) increases regional cerebral blood flow (rCBF) and ameliorates disorders of cerebral blood circulation. The aim of our study was to examine the effect of FNS on rCBF in cerebral...

  • Accuracy of perfusion-CT inpredicting malignant middle cerebral artery brain infarction. Dittrich, R.; Kloska, S.; Fischer, T.; Nam, E.; Ritter, M.; Seidensticker, P.; Heindel, W.; Nabavi, D.; Ringelstein, E. // Journal of Neurology;Jun2008, Vol. 255 Issue 6, p896 

    We performeda prospective study on patientswith middle cerebral artery(MCA) ischemic stroke to evaluatethe accuracy of perfusion-CT imaging(PCT) to predict the developmentof malignant brain infarction(MBI). 106 patients(women 37 %, mean age 65 years)underwent native cranial computedtomography...

  • Computed tomographic determinants of neurologic deterioration in patients with large middle cerebral artery infarctions. Manno, Edward M.; Nichols, Douglas A.; Fulgham, Jimmy R.; Wijdicks, Eelco F.M. // Mayo Clinic Proceedings;Feb2003, Vol. 78 Issue 2, p156 

    Objective: To identify specific radiographic features on computed tomographic (CT) imaging that can predict neurologic deterioration in patients with large middle cerebral artery (MCA) infarctions. Patients and Methods: We performed a 10-year retrospective review from...

  • Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study. Conijn, Mandy M. A.; Hendrikse, Jeroen; Zwanenburg, Jaco J. M.; Takahara, Taro; Geerlings, Mirjam I.; Mali, Willem P. Th. M.; Luijten, Peter R. // European Radiology;Dec2009, Vol. 19 Issue 12, p2986 

    The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the...

  • Visible infarction on computed tomography is an independent predictor of poor functional outcome after stroke, and not of haemorrhagic transformation. J.M. Wardlaw; T.M. West; P.A.G. Sandercock; S.C. Lewis; O. Mielke // Journal of Neurology, Neurosurgery & Psychiatry;Apr2003, Vol. 74 Issue 4, p452 

    Objectives: To examine a very large dataset to provide a robust answer to the question of whether visible infarction on computed tomography was (a) an independent predictor of functional outcome at all times up to 48 hours after stroke, and (b) independently associated with haemorrhagic...

  • Predisposing factors for cerebral infarction: the Oxfordshire community stroke project. Sandercock, P.A.G.; Warlow, C.P.; Jones, L.N.; Starkey, I.R. // BMJ: British Medical Journal (International Edition);1/14/89, Vol. 298 Issue 6666, p75 

    Examines the causative factors of cerebral infarction in Oxfordshire, England. Use of computed tomography; Risk factors for cerebral infarction; Difficulties in establishing a pathological type of stroke.

  • Infarction of the Right Medullary Pyramid. Hudon, Mark; Farb, Richard; Cooke, L. J.; Bell, K. E.; Becker, W. J. // Canadian Journal of Neurological Sciences;Nov2004, Vol. 31 Issue 4, p528 

    Focuses on the case of a patient that shows clinical features consistent with infarction of the right medullary pyramid. Medical history and description of patient regarding his health; Illustration of the patient's axial diffusion image; Result of coronal enhanced magnetic resonance angiography...

  • Sudden deafness without vertigo as a sole manifestation of AICA infarct. Gerace, Carmela; Pianura, Claudio // Neurological Sciences;Oct2008, Vol. 29 Issue 5, p371 

    The article reports on the case study about sudden deafness without vertigo as a manifestation of partial anterior inferior cerebellar artery (AICA) infarct . This paper highlights the sudden sensorineural deafness in idiopathic disease. It looks into the cases where patients experience acute...


Read the Article


Sign out of this library

Other Topics