ArticleInternational journal of stroke : official journal of the International Stroke Society2024
Analysis of brain edema in RHAPSODY.
Article in International journal of stroke : official journal of the International Stroke Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 6 citations in OpenAlex.
- Association of Short-Course Methylprednisolone Therapy With Early Composite Imaging Abnormalities in Patients With Early Neurological Deterioration After Endovascular Thrombectomy for Acute Ischemic Stroke.Revista de neurologia · 2026Article
- Interaction effect of rehabilitation initiation timing and hospitalization frequency on long-term functional outcomes after stroke in rural China: a retrospective cohort study.Frontiers in neurology · 2025Article
- Electromechanical Regulation Underlying Protein Nanoparticle-Induced Osmotic Pressure in Neurotoxic Edema.International journal of nanomedicine · 2025Article
- Comparison of Cerebral Saturation and Brain Net Water Uptake After Moderate Traumatic Brain Injury.Advances in experimental medicine and biology · 2024Article
- Novel advanced imaging techniques for cerebral oedema.Frontiers in neurology · 2024Review
- Pre-thrombolysis serum sodium concentration is associated with post-thrombolysis symptomatic intracranial hemorrhage in ischemic stroke patients.Frontiers in neurology · 2024Article
- Net water uptake and ASPECTS in predicting futile recanalization for acute large vessel occlusion stroke: insights from time window stratification.Frontiers in neurologyArticle
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Authors and funding
16 authors at 12 institutions in 2 countries.
Funding
Abstract
backgroundCerebral edema is a secondary complication of acute ischemic stroke, but its time course and imaging markers are not fully understood. Recently, net water uptake (NWU) has been proposed as a novel marker of edema.
aimsStudying the RHAPSODY trial cohort, we sought to characterize the time course of edema and test the hypothesis that NWU provides distinct information when added to traditional markers of cerebral edema after stroke by examining its association with other markers.
methodsA total of 65 patients had measurable supratentorial ischemic lesions. Patients underwent head computed tomography (CT), brain magnetic resonance imaging (MRI) scans, or both at the baseline visit and after 2, 7, 30, and 90 days following enrollment. CT and MRI scans were used to measure four imaging markers of edema: midline shift (MLS), hemisphere volume ratio (HVR), cerebrospinal fluid (CSF) volume, and NWU using semi-quantitative threshold analysis. Trajectories of the markers were summarized, as available. Correlations of the markers of edema were computed and the markers compared by clinical outcome. Regression models were used to examine the effect of 3K3A-activated protein C (APC) treatment.
resultsTwo measures of mass effect, MLS and HVR, could be measured on all imaging modalities, and had values available across all time points. Accordingly, mass effect reached a maximum level by day 7, normalized by day 30, and then reversed by day 90 for both measures. In the first 2 days after stroke, the change in CSF volume was associated with MLS (ρ = -0.57,
conclusionsExisting cerebral edema imaging markers potentially describe two distinct processes, including lesional water concentration (i.e. NWU) and mass effect (MLS, HVR, and CSF volume). These two types of imaging markers may represent distinct aspects of cerebral edema, which could be useful for future trials targeting this process.
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