ArticleNeurocritical care2014
Outcomes in severe middle cerebral artery ischemic stroke.
Article in Neurocritical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed.
- Radiomics analysis for predicting malignant cerebral edema in patients undergoing endovascular treatment for acute ischemic strokeDiagnostic and interventional radiology (Ankara, Turkey) · 2023Trial
- Blood pressure variability and outcome in acute severe stroke: A post hoc analysis of CHASE-A randomized controlled trial.Journal of clinical hypertension (Greenwich, Conn.) · 2021Trial
- A Location-Specific Hyperdense Area Score Predicts Severe Mass Effect after Thrombectomy.Neurocritical care · 2026Article
- Eosinophils, malignant brain edema, and functional outcome after mechanical thrombectomy: a mediation analysis.Frontiers in neurology · 2026Article
- Early Anticoagulation After Large Ischemic Stroke in the Initiation of Anticoagulation After Cardioembolic Stroke Study.Journal of clinical neurology (Seoul, Korea) · 2025Article
- Clinical course, causes of worsening, and outcomes of severe ischemic stroke: A prospective multicenter cohort study.Chinese medical journal · 2025Article
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- Resistin and In-Hospital Mortality in Patients with Acute Ischemic Stroke: A Prospective Study.Journal of clinical medicine · 2024Article
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- Task-dependent Alteration in Delta Band Corticomuscular Coherence during Standing in Chronic Stroke Survivors.medRxiv : the preprint server for health sciences · 2023Article
- Targeting foam cell formation to improve recovery from ischemic stroke.Neurobiology of disease · 2023Review
- Cerebrospinal fluid volume improves prediction of malignant edema after endovascular treatment of stroke.International journal of stroke : official journal of the International Stroke Society · 2023Article
- Long-Term Functionality Prediction for First Time Ischemic Middle Cerebral Artery Stroke Patients Receiving Conventional Medical Treatment.Neuropsychiatric disease and treatment · 2022Article
- Investigating the Precise Localization of the Grasping Action in the Mid-Cingulate Cortex and Future Directions.Frontiers in human neuroscience · 2022Article
- Exploring the predictive value of lesion topology on motor function outcomes in a porcine ischemic stroke model.Scientific reports · 2021Article
- Targeting Sensory and Motor Integration for Recovery of Movement After CNS Injury.Frontiers in neuroscience · 2021Review
- Neural Stem Cell Extracellular Vesicles Disrupt Midline Shift Predictive Outcomes in Porcine Ischemic Stroke Model.Translational stroke research · 2020Article
- Potential Therapies for Cerebral Edema After Ischemic Stroke: A Mini Review.Frontiers in aging neuroscience · 2020Review
- Prediction of Malignant Acute Middle Cerebral Artery Infarction via Computed Tomography Radiomics.Frontiers in neuroscience · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundSevere middle cerebral artery stroke (MCA) is associated with a high rate of morbidity and mortality. We assessed the hypothesis that patient-specific variables may be associated with outcomes. We also sought to describe under-recognized patient-centered outcomes.
methodsA consecutive, multi-institution, retrospective cohort of adult patients (≤70 years) was established from 2009 to 2011. We included patients with NIHSS score ≥15 and infarct volume ≥60 mL measured within 48 h of symptom onset. Malignant edema was defined as the development of midline brain shift of ≥5 mm in the first 5 days. Exclusion criterion was enrollment in any experimental trial. A univariate and multivariate logistic regression analysis was performed to model and predict the factors related to outcomes.
results46 patients (29 female, 17 male; mean age 57.3 ± 1.5 years) met study criteria. The mortality rate was 28% (n = 13). In a multivariate analysis, only concurrent anterior cerebral artery (ACA) involvement was associated with mortality (OR 9.78, 95% CI 1.15, 82.8, p = 0.04). In the malignant edema subgroup (n = 23, 58%), 4 died (17%), 7 underwent decompressive craniectomy (30%), 7 underwent tracheostomy (30%), and 15 underwent gastrostomy (65%).
conclusionsAdverse outcomes after severe stroke are common. Concurrent ACA involvement predicts mortality in severe MCA stroke. It is useful to understand the incidence of life-sustaining procedures, such as tracheostomy and gastrostomy, as well as factors that contribute to their necessity.
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