ArticleJournal of neuroimaging : official journal of the American Society of Neuroimaging2018
Comparative Analysis of Markers of Mass Effect after Ischemic Stroke.
Article in Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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Who cites it
14 citing papers in PubMed.
- Intravenous Glibenclamide Reduces Lesional Water Uptake in Large Hemispheric Infarction.Stroke · 2019Trial
- Predicting early severe midline shift in acute ischemic stroke Within 24 h of endovascular thrombectomy.Neuroradiology · 2026Article
- The paradoxical relationship of sensorimotor deficit and lesion volume in acute ischemic stroke.Journal of neuropathology and experimental neurology · 2025Article
- The value of electroencephalography features in the prognostic evaluation of large hemispheric infarction patients at different time intervals.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Association of clinical outcome and imaging endpoints in extensive ischemic stroke-comparing measures of cerebral edema.European radiology · 2024Article
- Analysis of brain edema in RHAPSODY.International journal of stroke : official journal of the International Stroke Society · 2024Article
- Novel advanced imaging techniques for cerebral oedema.Frontiers in neurology · 2024Review
- Bedside detection of intracranial midline shift using portable magnetic resonance imaging.Scientific reports · 2022Observational
- Cerebral edema after ischemic stroke: Pathophysiology and underlying mechanisms.Frontiers in neuroscience · 2022Review
- The Role of Edema in Subacute Lesion Progression After Treatment of Acute Ischemic Stroke.Frontiers in neurology · 2021Article
- Computed Tomography Based Score of Early Ischemic Changes Predicts Malignant Infarction.Frontiers in neurology · 2021Article
- Neural Stem Cell Extracellular Vesicles Disrupt Midline Shift Predictive Outcomes in Porcine Ischemic Stroke Model.Translational stroke research · 2020Article
- SUR1-TRPM4 channels, not KNeuroscience letters · 2020Review
- Imaging biomarkers of cerebral edema automatically extracted from routine CT scans of large vessel occlusion strokes.Journal of neuroimaging : official journal of the American Society of NeuroimagingArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
background and purposeMidline shift determined on magnetic resonance imaging (MRI) or computed tomography (CT) images is a well-validated marker of mass effect after large hemispheric infarction and associated with mortality. In this study, we targeted a population with moderately sized strokes. We compared midline shift to other imaging markers and determined their ability to predict long-term outcome.
methodsMRI scans were studied from the Echoplanar Imaging Thrombolysis Evaluation Trial (EPITHET) cohort. Midline shift, acute stroke lesion volume, lesional swelling volume, change in ipsilateral hemisphere volume, the ratio of ipsilateral to contralateral hemisphere volume, and the reduction in lateral ventricle volume were measured. The relationships of these markers with poor outcome (modified Rankin scale score 3-6 at day 90) were assessed. Receiver-operating characteristic (ROC) curves were generated to compare the performance of each metric.
resultsOf the 71 included patients, 59.2% had a poor outcome that was associated with significantly larger values for midline shift, lesional swelling volume, and ratio of hemisphere volumes. Lesional swelling volume, change in hemisphere volume, ratio of hemisphere volumes, and lateral ventricle displacement were each correlated with midline shift (Spearman r = .60, .49, .61, and -.56, respectively; all P < .0001). ROC curve analysis showed that lesional swelling volume (area under the curve [AUC] = .791) predicted poor outcome better than midline shift (AUC = .682). For predicting mortality, ROC curve analysis showed that these three markers were equivalent.
conclusionThe ratio of ipsilateral to contralateral hemisphere volume, baseline lesion volume and lesional swelling volume best predicted poor outcome across a spectrum of stroke sizes.
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Registered trials
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