scholarly journals Evaluation of Serum S100B as a Surrogate Marker for Long-term Outcome and Infarct Volume in Acute Middle Cerebral Artery Infarction

2005 ◽  
Vol 62 (7) ◽  
pp. 1130 ◽  
Author(s):  
Christian Foerch ◽  
Oliver C. Singer ◽  
Tobias Neumann-Haefelin ◽  
Richard du Mesnil de Rochemont ◽  
Helmuth Steinmetz ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Infarct Volume ◽  
Surrogate Marker ◽  
Middle Cerebral Artery Infarction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Serum S100b

Impact of infections on long-term outcome after severe middle cerebral artery infarction

2012 ◽  
Vol 319 (1-2) ◽  
pp. 15-17 ◽  
Author(s):  
Lena Ulm ◽  
Hendrik Harms ◽  
Stephanie Ohlraun ◽  
Peter Reimnitz ◽  
Andreas Meisel
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Middle Cerebral Artery Infarction ◽  
Term Outcome ◽  
Long Term Outcome

Long-Term Outcome and Quality of Life After Craniectomy in Speech-Dominant Swollen Middle Cerebral Artery Infarction

2014 ◽  
Vol 22 (1) ◽  
pp. 6-14 ◽  
Author(s):  
Jarle Sundseth ◽  
Antje Sundseth ◽  
Bente Thommessen ◽  
Lars G. Johnsen ◽  
Marianne Altmann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Middle Cerebral Artery Infarction ◽  
Term Outcome ◽  
Long Term Outcome

Decompressive hemicraniectomy in malignant middle cerebral artery infarction: an analysis of long-term outcome and factors in patient selection

2007 ◽  
Vol 106 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Ashok Pillai ◽  
Sajesh K. Menon ◽  
Satyendra Kumar ◽  
Kariyattil Rajeev ◽  
Anand Kumar ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Vegetative State ◽  
Functional Independence ◽  
Middle Cerebral Artery Infarction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Decompressive Hemicraniectomy ◽  
The Mean

Object Middle cerebral artery infarction often occurs at a younger age than other strokes and is associated with significant rates of mortality and morbidity. After a period of pessimism regarding decompressive hemicraniectomy in the management of acute stroke, the method has reemerged in the past decade. The present study was undertaken to assess the immediate and long-term outcome of this intervention and to help better define the selection criteria for surgery. Methods The authors conducted a nonrandomized prospective study using decompressive hemicraniectomy with duraplasty in patients at various stages of clinical deterioration due to a space-occupying middle cerebral artery infarct. Patients were assessed at 6 and 12 months postinfarction by using functional scales. Subjective reconsideration was assessed using a questionnaire. Twenty-six patients were included in the study. The mean age was 48.4 ± 11.2 years, and the mean preoperative Glasgow Coma Scale score was 9.9 ± 3.2. The median time from ictus to surgery was 54 hours (range 13–288 hours). The rate of survival at 1 year postsurgery was 73%. Among survivors, 33.3% were independent (Barthel Index [BI] > 95) and 55.6% were partially dependent (BI 60–95) at 1 year postsurgery, with 72% attaining the ability to walk independently by 1 year postsurgery. No patient remained in a vegetative state. The 1-year BI score was inversely related to patient age (r = − 0.47, p = 0.048). Conclusions Survival after decompressive hemicraniectomy was better than previously reported using medical management alone. A vegetative state was avoided and functional independence was possible, especially in younger patients. Increasing age was a statistically significant predictor of disability and long-term functional dependence.

scholarly journals Decompressive craniectomy for malignant middle cerebral artery territory infarct: an institutional experience

2020 ◽  
Vol 7 (8) ◽  
pp. 2506
Author(s):  
Ranjit Kumar ◽  
Brijesh Kumar Tiwari ◽  
Sanjeev Kumar Pandey
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Decompressive Craniectomy ◽  
Term Outcome ◽  
Focal Neurological Deficit ◽  
Effective Measure ◽  
Long Term Outcome ◽  
Mortality And Morbidity ◽  
One Year

Background: Decompressive craniectomy is the surgical procedure to reduce intracranial pressure, refractory to medical measures. We have described our experience associated with the clinical profile, radiological profile, postoperative status and long term outcome in patients with malignant middle cerebral artery (MCA) territory infarct.Methods: Data were collected from patients who underwent hemispheric decompressive craniectomy for malignant MCA territory infarct in our hospital from May 2014 to June 2019. Clinical, radiological, surgical profile and long term outcome were studied.Results: There were a total of 51 patients aged between 28 years to 76 years. Hypertension (70%) was the most common comorbidity associated. All the patients had at least one focal neurological deficit at the time of presentation. Mean time from the first symptoms to surgery was 2.4 days (about 58 hours). 7 patients died within one month of the surgery. Two third improved objectively within 1 month of surgery. Out of 44 patients, who survived beyond one month, none of the patients were functionally independent after one year of surgery (modified Rankin scale (mRS) of 0 or 1). The patients had a mean mRS of 3.8 at one year.Conclusions: Over several decades decompressive craniectomy has been found to be the most effective measure to reduce mortality and morbidity associated with malignant MCA territory infarct. Early surgery (<48 hours) in patients with good Glasgow Coma scale score reduces the mortality. Larger multicentric trials are required to look at the long term effect on morbidity and mortality.

Abstract W MP14: Early Infarct Growth Predicts Long-term Clinical Outcome in Ischemic Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Seung Min Kim ◽  
Deok Hee Lee ◽  
Sun U. Kwon ◽  
Sang Joon Kim ◽  
Jong S. Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Infarct Volume ◽  
Surrogate Marker ◽  
Characteristic Analysis ◽  
Prognostic Information ◽  
Term Outcome ◽  
Ischemic Lesion ◽  
Long Term Outcome

Background: Ischemic lesion is dynamically evolving during acute phase of stroke. However, it is still controversial whether early changes in ischemic lesion have a prognostic information in addition to clinical variables. We hypothesized that early infarct growth on diffusion-weighted imaging (DWI) might be independently associated with long-term outcome. Methods: This was a prospective study of acute ischemic stroke patients who underwent DWI at baseline (within 24 hours) and at 5-day after stroke onset. Early infarct growth was defined as the difference between the final and the baseline infarct volume. Clinical outcomes were assessed using the modified Rankin Scale (mRS) at 3 months. Univariate and multivariate analyses were performed to assess the relationship between early infarct growth and clinical outcomes. The cut-off values of early infarct growth predicting long-term clinical outcomes were estimated using receiver operating characteristic analysis. Results: Of total 409 patients included, 345 (84.4%) showed any early infarct growth (median, 0.63cm 3 , interquartile range, 0.11-6.33cm 3 ). After adjusting age, diabetes, baseline National Institutes of Health Stroke Scale, and baseline infarct volume by multiple logistic analysis, infarct growth was an independent predictor of poor clinical outcomes (for mRS 2-6, odds ratio [OR], 1.03, 95% confidence interval [CI], 1.002-1.06, p=0.04; and for mRS 3-6, OR, 1.03, 95% CI, 1.01-1.05, p=0.01). The cut-off values of early infarct growth discriminating between good and poor outcomes were 0.99cm 3 for mRS 0-1 vs. 2-6 (area under curve [AUC], 0.685, p<0.001) and 8.86cm 3 for mRS 0-2 vs. 3-6 (AUC, 0.736, p<0.001). Conclusions: Infarct growth within a week of symptom onset independently predicts 3-month clinical outcomes. This suggests that short-term changes in infarct volume may serve as a surrogate marker of long-term clinical outcomes after ischemic stroke.

scholarly journals Predicting the Long-Term Outcome after Subacute Stroke within the Middle Cerebral Artery Territory

2005 ◽  
Vol 1 (2) ◽  
pp. 148 ◽  
Author(s):  
Oh Young Bang ◽  
Hee Young Park ◽  
Jung Han Yoon ◽  
Seung Hyeon Yeo ◽  
Ji Won Kim ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Middle Cerebral Artery Territory ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Subacute Stroke
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