Evidence map›Paper›PMID 35148711›Full record

ArticleBMC neurology2022

The Hyperdense middle cerebral artery sign is associated with poor leptomeningeal collaterals in acute ischemic stroke: a retrospective study.

Ye Hong, Jinghuan Fang, Mengmeng Ma, Wei Su, Muke Zhou, Li Tang, Huairong Tang, Li He

Open access · goldAbstract read
In one paragraph

Article in BMC neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Ye Hong *Department of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China.
Jinghuan Fang *Department of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China.
Mengmeng MaDepartment of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China.
Wei SuDepartment of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China.
Muke ZhouDepartment of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China.
Li TangDepartment of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China.
Huairong TangDepartment of Health Management Center, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China. hx_tanghuairong@163.com.
Li HeDepartment of Neurology, West China Hospital of Sichuan University, Wainan Guoxue Xiang #37, Chengdu, 610041, Sichuan, China. heli2003new@126.com.
Sichuan University · CNShanghai Center for Brain Science and Brain-Inspired Technology · CNWest China Hospital of Sichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe hyperdense middle cerebral artery sign (HMCAS) is an early radiological marker to provide an early diagnosis and to identify ischemia. As reported, HMCAS is associated with heavy clot burden. Moreover, a heavy clot burden may cause obstruction of the orifices of arteries for leptomeningeal collateral flows and can lead to severe clinical conditions. However, the direct relationship between HMCAS and collateral flows remains unclear. Therefore, we explored the association between HMCAS and leptomeningeal collaterals in patients with acute ischemic stroke.

methodsConsecutive ischemic stroke patients were enrolled from January 2015 to April 2021. HMCAS appearance and collateral status were detected by multimodal computed tomography at admission. Logistic regression analyses helped to identify the association between HMCAS, collateral flows and stroke severity.

resultsIn 494 included patients, 180 (36.4%) presented with HMCAS. Ipsilateral collaterals were not seen or less prominent in patients with HMCAS (P < 0.001). The HMCAS appearance was significantly associated with less collaterals (odds ratio 5.17, 95% confidence interval 3.27-8.18, P < 0.001), internal carotid artery + M1/M1 occlusion, the initial stroke severity and follow-up outcomes. Subgroup analyses further confirmed HMCAS as an indicator of poor collaterals in ischemic stroke (all P values < 0.05).

conclusionsHMCAS is associated with poor leptomeningeal collaterals, the stroke severity and a poor neurological outcome. Therefore, the HMCAS appearance can act as an early warning sign for healthcare professionals to be alert for poor collateral flows and poor neurological outcomes in ischemic stroke patients with middle cerebral artery occlusion.

Indexed as

Brain IschemiaIschemic StrokeStrokeHumansInfarction, Middle Cerebral ArteryMiddle Cerebral ArteryRetrospective StudiesAcute ischemic strokeHyperdense middle cerebral artery signLeptomeningeal collaterals

Identifiers

PMID35148711
PMCPMC8832774
OpenAlexW4211048181

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.