PURPOSE: We retrospectively evaluated the effect of brain atrophy on the outcome of patients after a large cerebral infarct. METHODS: Between June 2003 and Oct 2008, 134 of 2975 patients with stroke were diagnosed as having a large cerebral infarct. The mean age of the patients was 70 (21-95) y. The mean infarct volume was 223.6±95.2 cm(3) (46.0-491.0). The inter-caudate distance (ICD) was calculated as an indicator of brain atrophy by measuring the hemi-ICD of the intact side and then multiplying by two to account for brain swelling at the infarct site. The mean ICD was 18.0±4.8 mm (9.6-37.6). RESULTS: Forty-nine (36.6%) patients experienced a malignant clinical outcome (MCO) during management in the hospital. Thirty-one (23.1%) patients had a favourable functional outcome (FO) (modified Rankin scale (mRS) ≤3) and 49 (36.6%) had an acceptable functional outcome (AO) (mRS≤4) at 6 months after stroke onset. In the multivariate analysis, brain atrophy (ICD≥20 mm) had a significant and independent protective effect on MCO (p=0.003; OR=0.137; 95% CI 0.037 to 0.503). With respect to FO, the age and infarct volume reached statistical significance (p<0.001, OR=0.844, 95% CI 0.781 to 0.913; p=0.006, OR=0.987, 95% CI 0.977 to 0.996, respectively). Brain atrophy (ICD≥20 mm) was negatively associated only with AO (p=0.022; OR=0.164; 95% CI 0.035 to 0.767). CONCLUSIONS: Brain atrophy may have an association with clinical outcome after a large stroke by a trend of saving patients from an MCO but also by interfering with their functional recovery.
PURPOSE: We retrospectively evaluated the effect of brain atrophy on the outcome of patients after a large cerebral infarct. METHODS: Between June 2003 and Oct 2008, 134 of 2975 patients with stroke were diagnosed as having a large cerebral infarct. The mean age of the patients was 70 (21-95) y. The mean infarct volume was 223.6±95.2 cm(3) (46.0-491.0). The inter-caudate distance (ICD) was calculated as an indicator of brain atrophy by measuring the hemi-ICD of the intact side and then multiplying by two to account for brain swelling at the infarct site. The mean ICD was 18.0±4.8 mm (9.6-37.6). RESULTS: Forty-nine (36.6%) patients experienced a malignant clinical outcome (MCO) during management in the hospital. Thirty-one (23.1%) patients had a favourable functional outcome (FO) (modified Rankin scale (mRS) ≤3) and 49 (36.6%) had an acceptable functional outcome (AO) (mRS≤4) at 6 months after stroke onset. In the multivariate analysis, brain atrophy (ICD≥20 mm) had a significant and independent protective effect on MCO (p=0.003; OR=0.137; 95% CI 0.037 to 0.503). With respect to FO, the age and infarct volume reached statistical significance (p<0.001, OR=0.844, 95% CI 0.781 to 0.913; p=0.006, OR=0.987, 95% CI 0.977 to 0.996, respectively). Brain atrophy (ICD≥20 mm) was negatively associated only with AO (p=0.022; OR=0.164; 95% CI 0.035 to 0.767). CONCLUSIONS:Brain atrophy may have an association with clinical outcome after a large stroke by a trend of saving patients from an MCO but also by interfering with their functional recovery.
Authors: Christoph Beck; Anna Kruetzelmann; Nils D Forkert; Eric Juettler; Oliver C Singer; Martin Köhrmann; Jan F Kersten; Jan Sobesky; Christian Gerloff; Jens Fiehler; Peter D Schellinger; Joachim Röther; Götz Thomalla Journal: J Neurol Date: 2014-04-01 Impact factor: 4.849
Authors: Pongpat Vorasayan; Matthew B Bevers; Lauren A Beslow; Gordon Sze; Bradley J Molyneaux; Holly E Hinson; J Marc Simard; Rüdiger von Kummer; Kevin N Sheth; W Taylor Kimberly Journal: Stroke Date: 2019-09-20 Impact factor: 7.914
Authors: Simone M Uniken Venema; Sandro Marini; Umme K Lena; Andrea Morotti; Michael Jessel; Charles J Moomaw; Christina Kourkoulis; Fernando D Testai; Steven J Kittner; H Bart Brouwers; Michael L James; Daniel Woo; Christopher D Anderson; Jonathan Rosand Journal: Stroke Date: 2019-08-26 Impact factor: 7.914
Authors: Kevin N Sheth; Nils H Petersen; Ken Cheung; Jordan J Elm; Holly E Hinson; Bradley J Molyneaux; Lauren A Beslow; Gordon K Sze; J Marc Simard; W Taylor Kimberly Journal: Stroke Date: 2018-05-22 Impact factor: 7.914