Evidence map›Paper›PMID 40038517›Full record

Observational studyScientific reports2025

The malignant stroke indicator is an early indicator of malignant ischemic stroke requiring decompressive hemicraniectomy.

Xenia Hautmann, Ala Jamous, Ilko Maier, Christoph Bettag, Silvia Hernandez Duran, Ruslan Muradzade, Dorothee Mielke, Veit Rohde, Vesna Malinova

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

9 authors.

Xenia HautmannDepartment of Neurosurgery, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
Ala JamousDepartment of Neuroradiology, University Medical Center Göttingen, Göttingen, Germany.
Ilko MaierDepartment of Neurology, University Medical Center Göttingen, Göttingen, Germany.
Christoph BettagDepartment of Neurosurgery, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
Silvia Hernandez DuranDepartment of Neurosurgery, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
Ruslan MuradzadeDepartment of Neurosurgery, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
Dorothee MielkeDepartment of Neurosurgery, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
Veit RohdeDepartment of Neurosurgery, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
Vesna MalinovaDepartment of Neurosurgery, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany. vesna.malinova@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Decompressive craniectomy (DHC) can prevent mortality in patients with malignant ischemic stroke. However, no clear criteria have been established to early identify patients, who will develop malignant stroke requiring DHC. In this retrospective observational study, a large patient cohort with ischemic stroke treated between 2010 and 2021, was analyzed. Clinical and radiological parameters were analyzed. Univariate and multivariate regression analyses were performed to identify the parameters to be included in the score. A cohort of 534 patients was included. A malignant stroke indicator (MSI) score was created including age < 70 years with 7 points, midline shift with up to 6 points, unsuccessful recanalization (TICI < 2b) with 6 points, basal cistern effacement with 4 points, and CBV ASPECTS < 6 with 3 points assigned. A MSI score with a cutoff value of 9 showed a high discrimination power concerning the need for DHC (AUC 0.90, p < 0.0001). Patients with MSI-score ≥ 9 had a 22-fold higher probability of needing DHC (odds ratio 22.90, p < 0.0001). The MSI score is a promising tool to predict the need for DHC in patients at risk for developing a malignant stroke and needs to be validated in external cohorts.

Indexed as

Decompressive CraniectomyIschemic StrokeAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsBrain edemaDecompressive hemicraniectomyMalignant ischemic stroke

Identifiers

PMID40038517
PMCPMC11880335

What OpenQuestion holds

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Registered trials

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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.