Evidence map›Paper›PMID 40954437›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025

CT hyperdensities after recanalization for anterior circulation large vessels occlusion: a predictor for malignant brain edema after ischemic stroke?

Alberto Ramponi, Andrea Di Cristofori, Francesca Graziano, Leonardo Fiori, Paolo Remida, Mirko Patassini, Andrea Galbiati, Simone Beretta, Stefania Galimberti, Giorgio Carrabba and 1 more

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In one paragraph

Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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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

2 citing papers in PubMed.

  1. Article
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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

11 authors.

Alberto Ramponi *Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy.
Andrea Di Cristofori *Neurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy. andrea.dicristofori@gmail.com.
Francesca GrazianoBiostatistics and Clinical Epidemiology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Leonardo FioriNeurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy.
Paolo RemidaNeuroradiology, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy.
Mirko PatassiniNeuroradiology, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy.
Andrea GalbiatiNeuroradiology, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy.
Simone BerettaDepartment of Medicine and Surgery, University of Milano-Bicocca, Ospedale San Gerardo, Milan, Italy.
Stefania GalimbertiBiostatistics and Clinical Epidemiology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Giorgio CarrabbaNeurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy.
Carlo GiussaniNeurosurgery, Fondazione IRCCS San Gerardo dei Tintori, Via G.B. Pergolesi 33, Monza, 20900, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment of acute ischemic stroke (AIS) management is early revascularization. Mechanical thrombectomy (MT) has emerged as a powerful treatment option for LVO. Although MT, some patients develop malignant brain edema with intracranial hypertension. Decompressive craniectomy (DC) has proven effective in managing intracranial hypertension and preventing early mortality when performed within 48 h of stroke onset.

objectivesOur study aims to investigate whether previous MT influences specific procedural aspects of DC. Additionally, we looked for potential radiological indicators that could be used in clinical practice to predict the need for DC following MT.

methodsOur retrospective study included patients that underwent DC for malignant anterior circulation AIS between January 2008 and December 2023 at Fondazione IRCCS San Gerardo dei Tintori. Only patients with anterior circulation large vessel AIS of thrombotic or embolic origin were included. Patients who underwent MT prior to DC were included in a first group (MT patients); while patients who did not underwent MT constituted the control group (non-MT patients).

resultsDC in MT patients was required after an average of 29.28 h from symptom onset, compared to 49.77 h in the control group (p < 0.005). Intraparenchymal hyperdensity was present at 12 h in 66.7% of cases in the first group and in 11.5% in the second group (p < 0.001). Midline shift was observed at 36 h in 18 MT patients in contrast to 12 patients in non-MT group (p = 0.012).

conclusionPatients undergoing MT for anterior circulation LVO may still require DC, even after achieving successful reperfusion. In this subgroup, a more rapid progression to malignant stroke has been observed.

Indexed as

Brain EdemaDecompressive CraniectomyIschemic StrokeAgedFemaleHumansMaleMiddle AgedRetrospective StudiesThrombectomyTomography, X-Ray ComputedCT hyperdensityDecompressive craniectomyIschemic strokeLarge vessels occlusionMechanical thrombectomySpace occupying ischemic lesions

Identifiers

PMID40954437

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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.