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Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core

BACKGROUND: Midline shift (MLS) is troublesome problem that may occur in patients with a large infarct core (LIC) and may be related to the baseline infarct core volume. The purpose of this study was to explore the relationship between baseline infarct core volume and early MLS presence. MATERIALS A...

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Autores principales: Yi, Ting-yu, Wu, Yan-min, Lin, Ding-lai, Lang, Feng-long, Yang, Yu-yan, Pan, Zhi-nan, Zheng, Xiu-fen, Hong, Gan-ji, Wu, Mei-hua, Lin, Xiao-hui, Chen, Rong-cheng, Zeng, Lisan, Chen, Wen-huo, Sui, Yi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868771/
https://www.ncbi.nlm.nih.gov/pubmed/36698883
http://dx.doi.org/10.3389/fneur.2022.1077824
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author Yi, Ting-yu
Wu, Yan-min
Lin, Ding-lai
Lang, Feng-long
Yang, Yu-yan
Pan, Zhi-nan
Zheng, Xiu-fen
Hong, Gan-ji
Wu, Mei-hua
Lin, Xiao-hui
Chen, Rong-cheng
Zeng, Lisan
Chen, Wen-huo
Sui, Yi
author_facet Yi, Ting-yu
Wu, Yan-min
Lin, Ding-lai
Lang, Feng-long
Yang, Yu-yan
Pan, Zhi-nan
Zheng, Xiu-fen
Hong, Gan-ji
Wu, Mei-hua
Lin, Xiao-hui
Chen, Rong-cheng
Zeng, Lisan
Chen, Wen-huo
Sui, Yi
author_sort Yi, Ting-yu
collection PubMed
description BACKGROUND: Midline shift (MLS) is troublesome problem that may occur in patients with a large infarct core (LIC) and may be related to the baseline infarct core volume. The purpose of this study was to explore the relationship between baseline infarct core volume and early MLS presence. MATERIALS AND METHODS: Patients with acute intracranial large artery occlusion and a pretreatment relative cerebral blood flow (rCBF) <30% volume ≥50 ml on CT perfusion (CTP) were included, clinical outcomes following endovascular treatment (EVT) were retrospectively analyzed. The primary endpoint was MLS within 48 h (early MLS presence). The association between baseline ICV and early MLS presence was evaluated with multivariable regression. RESULTS: Ultimately, 95 patients were included, and 29.5% (28/95) of the patients had early MLS. The number of patients with a baseline rCBF < 15% volume (median [interquartile range], 46 [32–60] vs. 29 [19–40]; P < 0.001) was significantly larger in the early severe MLS presence group. A baseline rCBF < 15% volume showed significantly better predictive accuracy for early MLS presence than an rCBF < 30% volume (area under the curve, 0.74 vs. 0.64, P = 0.0023). In addition, an rCBF < 15% volume ≥40 ml (odds ratio, 4.34 [95% CI, 1.571–11.996]) was associated with early MLS presence after adjustment for sex, age, baseline National Institutes of Health Stroke Scale score, onset-to-recanalization time. CONCLUSION: In patients with an acute LIC following EVT, a pretreatment infarct core volume > 40 ml based on an rCBF < 15% showed good predictive value for early MLS occurrence.
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spelling pubmed-98687712023-01-24 Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core Yi, Ting-yu Wu, Yan-min Lin, Ding-lai Lang, Feng-long Yang, Yu-yan Pan, Zhi-nan Zheng, Xiu-fen Hong, Gan-ji Wu, Mei-hua Lin, Xiao-hui Chen, Rong-cheng Zeng, Lisan Chen, Wen-huo Sui, Yi Front Neurol Neurology BACKGROUND: Midline shift (MLS) is troublesome problem that may occur in patients with a large infarct core (LIC) and may be related to the baseline infarct core volume. The purpose of this study was to explore the relationship between baseline infarct core volume and early MLS presence. MATERIALS AND METHODS: Patients with acute intracranial large artery occlusion and a pretreatment relative cerebral blood flow (rCBF) <30% volume ≥50 ml on CT perfusion (CTP) were included, clinical outcomes following endovascular treatment (EVT) were retrospectively analyzed. The primary endpoint was MLS within 48 h (early MLS presence). The association between baseline ICV and early MLS presence was evaluated with multivariable regression. RESULTS: Ultimately, 95 patients were included, and 29.5% (28/95) of the patients had early MLS. The number of patients with a baseline rCBF < 15% volume (median [interquartile range], 46 [32–60] vs. 29 [19–40]; P < 0.001) was significantly larger in the early severe MLS presence group. A baseline rCBF < 15% volume showed significantly better predictive accuracy for early MLS presence than an rCBF < 30% volume (area under the curve, 0.74 vs. 0.64, P = 0.0023). In addition, an rCBF < 15% volume ≥40 ml (odds ratio, 4.34 [95% CI, 1.571–11.996]) was associated with early MLS presence after adjustment for sex, age, baseline National Institutes of Health Stroke Scale score, onset-to-recanalization time. CONCLUSION: In patients with an acute LIC following EVT, a pretreatment infarct core volume > 40 ml based on an rCBF < 15% showed good predictive value for early MLS occurrence. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9868771/ /pubmed/36698883 http://dx.doi.org/10.3389/fneur.2022.1077824 Text en Copyright © 2023 Yi, Wu, Lin, Lang, Yang, Pan, Zheng, Hong, Wu, Lin, Chen, Zeng, Chen and Sui. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Yi, Ting-yu
Wu, Yan-min
Lin, Ding-lai
Lang, Feng-long
Yang, Yu-yan
Pan, Zhi-nan
Zheng, Xiu-fen
Hong, Gan-ji
Wu, Mei-hua
Lin, Xiao-hui
Chen, Rong-cheng
Zeng, Lisan
Chen, Wen-huo
Sui, Yi
Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core
title Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core
title_full Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core
title_fullStr Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core
title_full_unstemmed Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core
title_short Association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core
title_sort association of baseline core volume and early midline shift in acute stroke patients with a large ischaemic core
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868771/
https://www.ncbi.nlm.nih.gov/pubmed/36698883
http://dx.doi.org/10.3389/fneur.2022.1077824
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