Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Neurovascular Research
  4. Fast Track Articles
  5. Fast Track Article
image of Malignant Brain Edema and Associated Factors in Large Hemispheric Infarction Following Reperfusion Therapy

Abstract

Objective

This study aimed to explore Malignant Brain Edema (MBE) and associated factors in patients with Large Hemispheric Infarction (LHI) following early reperfusion therapy.

Methods

We consecutively and retrospectively enrolled a cohort of 114 LHI patients who had received early reperfusion therapy, including Intravenous Thrombolysis (IVT) or Endovascular Therapy (EVT) at the hyperacute stage of stroke between January 2009 and December 2018. MBE was defined as a midline shift ≥5 mm, accompanied by signs of herniation. Multivariate logistic analyses were conducted to identify independent factors associated with MBE in LHI patients following early reperfusion therapy.

Results

Among the enrolled patients, 69 (60.53%) were treated with IVT alone and 45 (39.47%) with EVT. Successful recanalization was achieved in 56 (49.12%) patients, while complete recanalization was achieved in 38 (33.33%) patients. After early reperfusion therapy, 50 (43.86%) developed MBE in LHI patients. The MBE group showed higher rates of in-hospital death (54% . 4.69%), 3-month mortality (64% . 10.94%), and 3-month unfavorable outcomes (90% . 64.06%) (all <0.01). Neither different reperfusion therapy (EVT . IVT alone) nor different recanalization status (complete recanalization or not) was independently associated with the development of MBE in LHI patients following reperfusion therapy in multivariate analyses. MBE was independently associated with age [Odds Ratio (OR) 0.953, 95% confidence interval (CI) 0.910-0.999, =0.044], right hemisphere stroke (OR 4.051, 95% CI 1.035-15.860, =0.045), previous ischemic stroke or TIA (OR 0.090, 95% CI 0.014-0.571, =0.011), and hypodensity >1/3 MCA territory (OR 8.071, 95% CI 1.878-34.693, =0.005). Meanwhile, patients with lower baseline Alberta Stroke Program Early CT Score (ASPECTS) had a trend of higher incidence of MBE following reperfusion therapy (OR 0.710, 95% CI 0.483-1.043, =0.081).

Conclusion

MBE occurred in nearly one-half of LHI patients following early reperfusion therapy and was related to poor outcomes. An increased risk of MBE was found to be associated with younger age, right hemisphere stroke, absence of a history of ischemic stroke or TIA, and hypodensity >1/3 MCA region on baseline CT images.

© 2024 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cnr/10.2174/0115672026363146241216075333
2024-12-26
2025-01-23

  • From This Site

    /content/journals/cnr/10.2174/0115672026363146241216075333
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Uhl E. Kreth F.W. Elias B. Goldammer A. Hempelmann R.G. Liefner M. Nowak G. Oertel M. Schmieder K. Schneider G.H. Outcome and prognostic factors of hemicraniectomy for space occupying cerebral infarction. J. Neurol. Neurosurg. Psychiatry 2004 75 2 270 274 14742603
    [Google Scholar]
  2. Huttner H.B. Schwab S. Malignant middle cerebral artery infarction: Clinical characteristics, treatment strategies, and future perspectives. Lancet Neurol. 2009 8 10 949 958 10.1016/S1474‑4422(09)70224‑8 19747656
    [Google Scholar]
  3. Hacke W. Schwab S. Horn M. Spranger M. De Georgia M. von Kummer R. ‘Malignant’ middle cerebral artery territory infarction: Clinical course and prognostic signs. Arch. Neurol. 1996 53 4 309 315 10.1001/archneur.1996.00550040037012 8929152
    [Google Scholar]
  4. Berrouschot J. Sterker M. Bettin S. Köster J. Schneider D. Mortality of space-occupying (‘malignant’) middle cerebral artery infarction under conservative intensive care. Intensive Care Med. 1998 24 6 620 623 10.1007/s001340050625 9681786
    [Google Scholar]
  5. Frank J.I. Large hemispheric infarction, deterioration, and intracranial pressure. Neurology 1995 45 7 1286 1290 10.1212/WNL.45.7.1286 7617183
    [Google Scholar]
  6. Steiner T. Ringleb P. Hacke W. Treatment options for large hemispheric stroke. Neurology 2001 57 5 Suppl. 2 S61 S68 11552058
    [Google Scholar]
  7. Vahedi K. Hofmeijer J. Juettler E. Vicaut E. George B. Algra A. Amelink G.J. Schmiedeck P. Schwab S. Rothwell P.M. Bousser M.G. van der Worp H.B. Hacke W. DECIMAL, DESTINY, and HAMLET investigators Early decompressive surgery in malignant infarction of the middle cerebral artery: A pooled analysis of three randomised controlled trials. Lancet Neurol. 2007 6 3 215 222 10.1016/S1474‑4422(07)70036‑4 17303527
    [Google Scholar]
  8. Wardlaw J.M. Murray V. Berge E. del Zoppo G. Sandercock P. Lindley R.L. Cohen G. Recombinant tissue plasminogen activator for acute ischaemic stroke: An updated systematic review and meta-analysis. Lancet 2012 379 9834 2364 2372 10.1016/S0140‑6736(12)60738‑7 22632907
    [Google Scholar]
  9. Koga M. Arihiro S. Miyashita F. Yamamoto H. Yamada N. Nagatsuka K. Minematsu K. Toyoda K. Factors associated with early recanalization failure following intravenous rt-PA therapy for ischemic stroke. Cerebrovasc. Dis. 2013 36 4 299 305 10.1159/000355054 24135558
    [Google Scholar]
  10. Seners P. Turc G. Maïer B. Mas J.L. Oppenheim C. Baron J.C. Incidence and predictors of early recanalization after intravenous thrombolysis: A systematic review and meta-analysis. Stroke 2016 47 9 2409 2412 10.1161/STROKEAHA.116.014181 27462117
    [Google Scholar]
  11. Goyal M. Menon B.K. van Zwam W.H. Dippel D.W.J. Mitchell P.J. Demchuk A.M. Dávalos A. Majoie C.B.L.M. van der Lugt A. de Miquel M.A. Donnan G.A. Roos Y.B.W.E.M. Bonafe A. Jahan R. Diener H.C. van den Berg L.A. Levy E.I. Berkhemer O.A. Pereira V.M. Rempel J. Millán M. Davis S.M. Roy D. Thornton J. Román L.S. Ribó M. Beumer D. Stouch B. Brown S. Campbell B.C.V. van Oostenbrugge R.J. Saver J.L. Hill M.D. Jovin T.G. HERMES collaborators Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet 2016 387 10029 1723 1731 10.1016/S0140‑6736(16)00163‑X 26898852
    [Google Scholar]
  12. Nogueira R.G. Jadhav A.P. Haussen D.C. Bonafe A. Budzik R.F. Bhuva P. Yavagal D.R. Ribo M. Cognard C. Hanel R.A. Sila C.A. Hassan A.E. Millan M. Levy E.I. Mitchell P. Chen M. English J.D. Shah Q.A. Silver F.L. Pereira V.M. Mehta B.P. Baxter B.W. Abraham M.G. Cardona P. Veznedaroglu E. Hellinger F.R. Feng L. Kirmani J.F. Lopes D.K. Jankowitz B.T. Frankel M.R. Costalat V. Vora N.A. Yoo A.J. Malik A.M. Furlan A.J. Rubiera M. Aghaebrahim A. Olivot J.M. Tekle W.G. Shields R. Graves T. Lewis R.J. Smith W.S. Liebeskind D.S. Saver J.L. Jovin T.G. DAWN Trial Investigators Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N. Engl. J. Med. 2018 378 1 11 21 10.1056/NEJMoa1706442 29129157
    [Google Scholar]
  13. Albers G.W. Marks M.P. Kemp S. Christensen S. Tsai J.P. Ortega-Gutierrez S. McTaggart R.A. Torbey M.T. Kim-Tenser M. Leslie-Mazwi T. Sarraj A. Kasner S.E. Ansari S.A. Yeatts S.D. Hamilton S. Mlynash M. Heit J.J. Zaharchuk G. Kim S. Carrozzella J. Palesch Y.Y. Demchuk A.M. Bammer R. Lavori P.W. Broderick J.P. Lansberg M.G. DEFUSE 3 Investigators Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N. Engl. J. Med. 2018 378 8 708 718 10.1056/NEJMoa1713973 29364767
    [Google Scholar]
  14. Bellwald S. Weber R. Dobrocky T. Nordmeyer H. Jung S. Hadisurya J. Mordasini P. Mono M.L. Stracke C.P. Sarikaya H. Bernasconi C. Berger K. Arnold M. Chapot R. Gralla J. Fischer U. Direct mechanical intervention versus bridging therapy in stroke patients eligible for intravenous thrombolysis: A pooled analysis of 2 registries. Stroke 2017 48 12 3282 3288 10.1161/STROKEAHA.117.018459 29114095
    [Google Scholar]
  15. Coutinho J.M. Liebeskind D.S. Slater L.A. Nogueira R.G. Clark W. Dávalos A. Bonafé A. Jahan R. Fischer U. Gralla J. Saver J.L. Pereira V.M. Combined intravenous thrombolysis and thrombectomy vs thrombectomy alone for acute ischemic stroke: A pooled analysis of the SWIFT and STAR studies. JAMA Neurol. 2017 74 3 268 274 10.1001/jamaneurol.2016.5374 28097310
    [Google Scholar]
  16. Kaesmacher J. Mordasini P. Arnold M. López-Cancio E. Cerdá N. Boeckh-Behrens T. Kleine J.F. Goyal M. Hill M.D. Pereira V.M. Saver J.L. Gralla J. Fischer U. Direct mechanical thrombectomy in tPA-ineligible and -eligible patients versus the bridging approach: A meta-analysis. J. Neurointerv. Surg. 2019 11 1 20 27 10.1136/neurintsurg‑2018‑013834 29705773
    [Google Scholar]
  17. Yang P. Zhang Y. Zhang L. Zhang Y. Treurniet K.M. Chen W. Peng Y. Han H. Wang J. Wang S. Yin C. Liu S. Wang P. Fang Q. Shi H. Yang J. Wen C. Li C. Jiang C. Sun J. Yue X. Lou M. Zhang M. Shu H. Sun D. Liang H. Li T. Guo F. Ke K. Yuan H. Wang G. Yang W. Shi H. Li T. Li Z. Xing P. Zhang P. Zhou Y. Wang H. Xu Y. Huang Q. Wu T. Zhao R. Li Q. Fang Y. Wang L. Lu J. Li Y. Fu J. Zhong X. Wang Y. Wang L. Goyal M. Dippel D.W.J. Hong B. Deng B. Roos Y.B.W.E.M. Majoie C.B.L.M. Liu J. DIRECT-MT Investigators Endovascular thrombectomy with or without intravenous alteplase in acute stroke. N. Engl. J. Med. 2020 382 21 1981 1993 10.1056/NEJMoa2001123 32374959
    [Google Scholar]
  18. shimoyama T. The Dash score: A simple score to assess risk for development of malignant middle cerebral artery infarction. J. Neurol. Sci. 2014 338 102 106
    [Google Scholar]
  19. Kim H. Predictors of malignant brain edema in middle cerebral artery infarction observed on cT angiography. J. Clin. Neurosci. 2015 22 554 560
    [Google Scholar]
  20. Horsch AD. Imaging findings associated with space-occupying edema in patients with large middle cerebral artery infarcts. AJNR Am. J. Neuroradiol. 2016 37 831 837
    [Google Scholar]
  21. Hofmeijer J. Algra A. Kappelle L.J. van der Worp H.B. Predictors of life-threatening brain edema in middle cerebral artery infarction. Cerebrovasc. Dis. 2008 25 1-2 176 184 10.1159/000113736 18212524
    [Google Scholar]
  22. Wu S. Yuan R. Wang Y. Wei C. Zhang S. Yang X. Wu B. Liu M. Early prediction of malignant brain edema after ischemic stroke. Stroke 2018 49 12 2918 2927 10.1161/STROKEAHA.118.022001 30571414
    [Google Scholar]
  23. Huang X. Yang Q. Shi X. Xu X. Ge L. Ding X. Zhou Z. Predictors of malignant brain edema after mechanical thrombectomy for acute ischemic stroke. J. Neurointerv. Surg. 2019 11 10 994 998 10.1136/neurintsurg‑2018‑014650 30798266
    [Google Scholar]
  24. Kong F.Y. Tao W.D. Hao Z.L. Liu M. Predictors of one-year disability and death in Chinese hospitalized women after ischemic stroke. Cerebrovasc. Dis. 2010 29 3 255 262 10.1159/000267852 20029199
    [Google Scholar]
  25. Lei C. Wu B. Liu M. Chen Y. Yang H. Wang D. Lin S. Hao Z. Totaled health risks in vascular events score predicts clinical outcomes in patients with cardioembolic and other subtypes of ischemic stroke. Stroke 2014 45 6 1689 1694 10.1161/STROKEAHA.113.004352 24743443
    [Google Scholar]
  26. de Haan R. Limburg M. Bossuyt P. van der Meulen J. Aaronson N. The clinical meaning of Rankin ‘handicap’ grades after stroke. Stroke 1995 26 11 2027 2030 10.1161/01.STR.26.11.2027 7482643
    [Google Scholar]
  27. Adams H.P. Jr Bendixen B.H. Kappelle L.J. Biller J. Love B.B. Gordon D.L. Marsh E.E. III Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of org 10172 in acute stroke treatment. Stroke 1993 24 1 35 41 10.1161/01.STR.24.1.35 7678184
    [Google Scholar]
  28. Topcuoglu M.A. Arsava E.M. Kursun O. Akpinar E. Erbil B. The utility of middle cerebral artery clot density and burden assessment by noncontrast computed tomography in acute ischemic stroke patients treated with thrombolysis. J. Stroke Cerebrovasc. Dis. 2014 23 2 e85 e91 10.1016/j.jstrokecerebrovasdis.2013.08.026 24119367
    [Google Scholar]
  29. Kalafut M.A. Schriger D.L. Saver J.L. Starkman S. Detection of early CT signs of >1/3 middle cerebral artery infarctions : Interrater reliability and sensitivity of CT interpretation by physicians involved in acute stroke care. Stroke 2000 31 7 1667 1671 10.1161/01.STR.31.7.1667 10884471
    [Google Scholar]
  30. Pexman J.H.W. Barber P.A. Hill M.D. Sevick R.J. Demchuk A.M. Hudon M.E. Hu W.Y. Buchan A.M. Use of the alberta stroke program early CT score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am. J. Neuroradiol. 2001 22 8 1534 1542 11559501
    [Google Scholar]
  31. Zaidat O.O. Yoo A.J. Khatri P. Tomsick T.A. von Kummer R. Saver J.L. Marks M.P. Prabhakaran S. Kallmes D.F. Fitzsimmons B.F.M. Mocco J. Wardlaw J.M. Barnwell S.L. Jovin T.G. Linfante I. Siddiqui A.H. Alexander M.J. Hirsch J.A. Wintermark M. Albers G. Woo H.H. Heck D.V. Lev M. Aviv R. Hacke W. Warach S. Broderick J. Derdeyn C.P. Furlan A. Nogueira R.G. Yavagal D.R. Goyal M. Demchuk A.M. Bendszus M. Liebeskind D.S. Cerebral Angiographic Revascularization Grading (CARG) Collaborators STIR Revascularization working group STIR Thrombolysis in Cerebral Infarction (TICI) Task Force Recommendations on angiographic revascularization grading standards for acute ischemic stroke: A consensus statement. Stroke 2013 44 9 2650 2663 10.1161/STROKEAHA.113.001972 23920012
    [Google Scholar]
  32. Ospel J M Singh N Almekhlafi M A Early recanalization with alteplase in stroke because of large vessel occlusion in the escape trial. Stroke 2020 52 1 304 307
    [Google Scholar]
  33. Kimberly W.T. Dutra B.G. Boers A.M.M. Alves H.C.B.R. Berkhemer O.A. van den Berg L. Sheth K.N. Roos Y.B.W.E.M. van der Lugt A. Beenen L.F.M. Dippel D.W.J. van Zwam W.H. van Oostenbrugge R.J. Lingsma H.F. Marquering H. Majoie C.B.L.M. MR CLEAN Investigators Association of reperfusion with brain edema in patients with acute ischemic stroke. JAMA Neurol. 2018 75 4 453 461 10.1001/jamaneurol.2017.5162 29365017
    [Google Scholar]
  34. Hacke W. Kaste M. Fieschi C. von Kummer R. Davalos A. Meier D. Larrue V. Bluhmki E. Davis S. Donnan G. Schneider D. Diez-Tejedor E. Trouillas P. Second European-Australasian Acute Stroke Study Investigators Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet 1998 352 9136 1245 1251 10.1016/S0140‑6736(98)08020‑9 9788453
    [Google Scholar]
  35. Jauch E.C. Saver J.L. Adams H.P. Jr Bruno A. Connors J.J.B. Demaerschalk B.M. Khatri P. McMullan P.W. Jr Qureshi A.I. Rosenfield K. Scott P.A. Summers D.R. Wang D.Z. Wintermark M. Yonas H. American Heart Association Stroke Council Council on Cardiovascular Nursing Council on Peripheral Vascular Disease Council on Clinical Cardiology Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the american heart association/american stroke association. Stroke 2013 44 3 870 947 10.1161/STR.0b013e318284056a 23370205
    [Google Scholar]
  36. William J. Colin P. José B. 2015 american heart association/american stroke association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment A guideline for healthcare professionals from the American H. Int. J. Cerebrovasc. Dis. 2015 23 11 801 814
    [Google Scholar]
  37. Johnston K.C. Li J.Y. Lyden P.D. Hanson S.K. Feasby T.E. Adams R.J. Faught R.E. Jr Haley E.C. Jr RANTTAS Investigators Medical and neurological complications of ischemic stroke: Experience from the RANTTAS trial. Stroke 1998 29 2 447 453 10.1161/01.STR.29.2.447 9472888
    [Google Scholar]
  38. Hacke W. Kaste M. Bluhmki E. Brozman M. Dávalos A. Guidetti D. Larrue V. Lees K.R. Medeghri Z. Machnig T. Schneider D. von Kummer R. Wahlgren N. Toni D. ECASS Investigators Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N. Engl. J. Med. 2008 359 13 1317 1329 10.1056/NEJMoa0804656 18815396
    [Google Scholar]
  39. Thomalla G. Simonsen C.Z. Boutitie F. Andersen G. Berthezene Y. Cheng B. Cheripelli B. Cho T.H. Fazekas F. Fiehler J. Ford I. Galinovic I. Gellissen S. Golsari A. Gregori J. Günther M. Guibernau J. Häusler K.G. Hennerici M. Kemmling A. Marstrand J. Modrau B. Neeb L. Perez de la Ossa N. Puig J. Ringleb P. Roy P. Scheel E. Schonewille W. Serena J. Sunaert S. Villringer K. Wouters A. Thijs V. Ebinger M. Endres M. Fiebach J.B. Lemmens R. Muir K.W. Nighoghossian N. Pedraza S. Gerloff C. WAKE-UP Investigators MRI-guided thrombolysis for stroke with unknown time of onset. N. Engl. J. Med. 2018 379 7 611 622 10.1056/NEJMoa1804355 29766770
    [Google Scholar]
  40. Strbian D. Meretoja A. Putaala J. Kaste M. Tatlisumak T. Helsinki Stroke Thrombolysis Registry Group Cerebral edema in acute ischemic stroke patients treated with intravenous thrombolysis. Int. J. Stroke 2013 8 7 529 534 10.1111/j.1747‑4949.2012.00781.x 22405327
    [Google Scholar]
  41. Thorén M. Azevedo E. Dawson J. Egido J.A. Falcou A. Ford G.A. Holmin S. Mikulik R. Ollikainen J. Wahlgren N. Ahmed N. Predictors for cerebral edema in acute ischemic stroke treated with intravenous thrombolysis. Stroke 2017 48 9 2464 2471 10.1161/STROKEAHA.117.018223 28775140
    [Google Scholar]
  42. Davoli A. Motta C. Koch G. Diomedi M. Napolitano S. Giordano A. Panella M. Morosetti D. Fabiano S. Floris R. Gandini R. Sallustio F. Pretreatment predictors of malignant evolution in patients with ischemic stroke undergoing mechanical thrombectomy. J. Neurointerv. Surg. 2018 10 4 340 344 10.1136/neurintsurg‑2017‑013224 28798267
    [Google Scholar]
  43. Tracol C. Vannier S. Hurel C. Tuffier S. Eugene F. Le Reste P.J. Predictors of malignant middle cerebral artery infarction after mechanical thrombectomy. Rev. Neurol. 2020 176 7-8 619 625 10.1016/j.neurol.2020.01.352 32624178
    [Google Scholar]
  44. Irvine H.J. Ostwaldt A.C. Bevers M.B. Dixon S. Battey T.W.K. Campbell B.C.V. Davis S.M. Donnan G.A. Sheth K.N. Jahan R. Saver J.L. Kidwell C.S. Kimberly W.T. Reperfusion after ischemic stroke is associated with reduced brain edema. J. Cereb. Blood Flow Metab. 2018 38 10 1807 1817 10.1177/0271678X17720559 28731381
    [Google Scholar]
  45. Gartshore G. Patterson J. Macrae I.M. Influence of ischemia and reperfusion on the course of brain tissue swelling and blood-brain barrier permeability in a rodent model of transient focal cerebral ischemia. Exp. Neurol. 1997 147 2 353 360 10.1006/exnr.1997.6635 9344560
    [Google Scholar]
  46. Pillai D.R. Dittmar M.S. Baldaranov D. Heidemann R.M. Henning E.C. Schuierer G. Bogdahn U. Schlachetzki F. Cerebral ischemia-reperfusion injury in rats--a 3 T MRI study on biphasic blood-brain barrier opening and the dynamics of edema formation. J. Cereb. Blood Flow Metab. 2009 29 11 1846 1855 10.1038/jcbfm.2009.106 19654585
    [Google Scholar]
  47. Simard J.M. Kent T.A. Chen M. Tarasov K.V. Gerzanich V. Brain oedema in focal ischaemia: Molecular pathophysiology and theoretical implications. Lancet Neurol. 2007 6 3 258 268 10.1016/S1474‑4422(07)70055‑8 17303532
    [Google Scholar]
  48. Cheripelli B.K. Huang X. MacIsaac R. Muir K.W. Interaction of recanalization, intracerebral hemorrhage, and cerebral edema after intravenous thrombolysis. Stroke 2016 47 7 1761 1767 10.1161/STROKEAHA.116.013142 27301943
    [Google Scholar]
  49. Fink J.N. Selim M.H. Kumar S. Silver B. Linfante I. Caplan L.R. Schlaug G. Is the association of National Institutes of Health Stroke Scale scores and acute magnetic resonance imaging stroke volume equal for patients with right- and left-hemisphere ischemic stroke? Stroke 2002 33 4 954 958 10.1161/01.STR.0000013069.24300.1D 11935043
    [Google Scholar]
  50. Rastogi V. Lamb D.G. Williamson J.B. Stead T.S. Penumudi R. Bidari S. Ganti L. Heilman K.M. Hedna V.S. Hemispheric differences in malignant middle cerebral artery stroke. J. Neurol. Sci. 2015 353 1-2 20 27 10.1016/j.jns.2015.04.036 25959980
    [Google Scholar]
  51. Yoon B.W. Morillo C.A. Cechetto D.F. Hachinski V. Cerebral hemispheric lateralization in cardiac autonomic control. Arch. Neurol. 1997 54 6 741 744 10.1001/archneur.1997.00550180055012 9193209
    [Google Scholar]
  52. Kroppenstedt S.N. Sakowitz O.W. Thomale U.W. Unterberg A.W. Stover J.F. Influence of norepinephrine and dopamine on cortical perfusion, EEG activity, extracellular glutamate, and brain edema in rats after controlled cortical impact injury. J. Neurotrauma 2002 19 11 1421 1432 10.1089/089771502320914651 12490007
    [Google Scholar]
  53. Ameli P.A. Ameli N.J. Gubernick D.M. Ansari S. Mohan S. Satriotomo I. Buckley A.K. Maxwell C.W. Jr Nayak V.H. Shushrutha Hedna V. Role of vasopressin and its antagonism in stroke related edema. J. Neurosci. Res. 2014 92 9 1091 1099 10.1002/jnr.23407 24823792
    [Google Scholar]
/content/journals/cnr/10.2174/0115672026363146241216075333
Loading
Malignant Brain Edema and Associated Factors in Large Hemispheric Infarction Following Reperfusion Therapy
Bentham Science Publishers ; https://doi.org/10.2174/0115672026363146241216075333
/content/journals/cnr/10.2174/0115672026363146241216075333
/content/journals/cnr/10.2174/0115672026363146241216075333
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: Large hemispheric infarction ; endovascular interventions ; intravenous thrombolysis ; malignant brain edema

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test