ArticleNeurocritical care2018
Defining the Optimal Midline Shift Threshold to Predict Poor Outcome in Patients with Supratentorial Spontaneous Intracerebral Hemorrhage.
Article in Neurocritical care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Impact of Minimally Invasive Surgery on Midline Shift and Outcomes in Large Supratentorial Spontaneous Intracerebral Hemorrhage: Post Hoc Analysis of MISTIE III.Neurocritical care · 2026Trial
- A decision tree model for hematoma expansion prediction in women after spontaneous intracerebral hemorrhage.Frontiers in neurology · 2026Article
- The role of imaging in predicting 3-month prognosis of primary intracerebral hemorrhage: a single-center, prospective observational study in tertiary care hospital.Quantitative imaging in medicine and surgery · 2025Article
- Early NCCT imaging signs for prognostication in intracerebral hemorrhage: a retrospective cohort study with long follow up results.BMC neurology · 2025Article
- Nomogram based on pan-immune-inflammation value to predict short-term prognosis in spontaneous intracerebral hemorrhage.Frontiers in neurology · 2025Article
- Development and validation of a predictive model for postoperative functional recovery in patients with spontaneous intracerebral hemorrhage.Frontiers in surgery · 2025Article
- Predictors and lesion patterns of dysphagia and swallowing outcomes after acute intracerebral hemorrhage.Therapeutic advances in neurological disorders · 2025Article
- Can the radiomics features of intracranial aneurysms predict the prognosis of aneurysmal subarachnoid hemorrhage?Frontiers in neuroscience · 2024Article
- The relationship between perihematomal edema and hematoma expansion in acute spontaneous intracerebral hemorrhage: an exploratory radiomics analysis study.Frontiers in neuroscience · 2024Article
- Cranial midline shift is a predictor of the clinical prognosis of acute cerebral infarction patients undergoing emergency endovascular treatment.Scientific reports · 2023Article
- Thrombolysis Outcomes in Acute Ischaemic Stroke Patients with Pre-Existing Cognitive Impairment.Life (Basel, Switzerland) · 2023Article
- Outcome Prediction of Spontaneous Supratentorial Intracerebral Hemorrhage after Surgical Treatment Based on Non-Contrast Computed Tomography: A Multicenter Study.Journal of clinical medicine · 2023Article
- Fecal microbial transplantation limits neural injury severity and functional deficits in a pediatric piglet traumatic brain injury model.Frontiers in neuroscience · 2023Article
- Risk factors for poor outcomes of spontaneous supratentorial cerebral hemorrhage after surgery.Journal of neurology · 2022Article
- A Robust, Fully Automatic Detection Method and Calculation Technique of Midline Shift in Intracranial Hemorrhage and Its Clinical Application.Diagnostics (Basel, Switzerland) · 2022Article
- Bedside detection of intracranial midline shift using portable magnetic resonance imaging.Scientific reports · 2022Observational
- Radiomics for predicting revised hematoma expansion with the inclusion of intraventricular hemorrhage growth in patients with supratentorial spontaneous intraparenchymal hematomas.Annals of translational medicine · 2022Article
- A Nomogram Based on CT Radiomics and Clinical Risk Factors for Prediction of Prognosis of Hypertensive Intracerebral Hemorrhage.Computational intelligence and neuroscience · 2022Article
- Development and Validation of a Clinical-Based Signature to Predict the 90-Day Functional Outcome for Spontaneous Intracerebral Hemorrhage.Frontiers in aging neuroscience · 2022Article
- A clinical-radiomics nomogram may provide a personalized 90-day functional outcome assessment for spontaneous intracerebral hemorrhage.European radiology · 2021Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundMidline shift (MLS) has been associated with unfavorable outcome in patients with intracerebral hemorrhage (ICH). However, the optimal criteria to define the MLS measurements that indicate future outcome in ICH patients are absent, and the quantitative threshold of MLS that differentiates favorable and poor clinical outcome should be further explored.
methodsWe enrolled patients with ICH who underwent admission computed tomography (CT) within 6 h after onset of symptoms. We assessed MLS at several locations, including the pineal gland, septum pellucidum, and cerebral falx. MLS(max) was defined as the maximum midline shift among these locations. Functional outcomes were assessed with the Modified Rankin Scale (mRS) at 3 months. We performed multivariate logistic regression analysis to investigate the MLS locations for predicting poor outcome. ROC curve analysis was used to establish whether MLS values were predictive of 90-day poor outcome.
resultsIn 199 patients with ICH, 78 (39.2%) patients had poor functional outcome at 3-month follow-up. Pineal gland shift, septum pellucidum shift, cerebral falx shift, and MLS(max) all showed a significant difference between poor outcome and favorable outcome (p < 0.001). After adjustment for age, baseline Glasgow Coma Scale score, ICH location, time to initial CT, baseline ICH volume, and intraventricular hemorrhage, the MLS(max) was independently associated with poor outcome (p = 0.032). MLS(max) > 4 mm (our proposed optimal threshold) was more likely to have poorer outcomes than those without (p < 0.001).
conclusionsMLS(max) can be a good independent predictor of clinical outcome, and MLS(max) > 4 mm is an optimal threshold associated with poor outcome in patients with ICH.
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