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Huang X, Wang H, Ji Y, Tao C, Shang X, Ni C, Xu J, Xu X, Hu W, Zhou Z. Incidence, predictors, and outcomes of malignant cerebral edema in acute basilar artery occlusion after endovascular treatment: a secondary analysis of the ATTENTION trial. J Neurosurg 2024:1-9. [PMID: 38579342 DOI: 10.3171/2024.1.jns232085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/18/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE Malignant cerebral edema (MCE) is a life-threatening complication of ischemic stroke. Few studies have evaluated MCE in patients with acute basilar artery occlusion (BAO) receiving endovascular treatment (EVT). Therefore, the authors investigated the incidence, predictors, and functional outcomes of MCE in BAO patients undergoing EVT. METHODS This was a post hoc analysis of the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) trial, a prospective, randomized, multicenter clinical trial that compared endovascular treatment with conventional care of patients with BAO at 36 centers in China. Brain edema was retrospectively assessed using the Jauss score for all available follow-up scans, and patients with a Jauss score ≥ 4 were classified as having MCE. Clinical functional independence was defined as a modified Rankin Scale (mRS) score of 0-2, and a good outcome was defined as an mRS score of 0-3 at the 90-day follow-up. Univariate and multivariate analyses were used to explore the predictors of MCE and the impact of MCE on prognosis. RESULTS A total of 189 patients were analyzed, and 13.2% of patients developed MCE. Multivariate analysis showed that the baseline Glasgow Coma Scale (GCS) score (OR 0.722, 95% CI 0.548-0.950; p = 0.020) and the number of procedures (OR 1.594, 95% CI 1.051-2.419; p = 0.028) were significantly associated with MCE. After adjusting for confounding factors, the presence of MCE was significantly associated with a lower rate of functional independence (OR 0.115, 95% CI 0.023-0.563; p = 0.008), a lower rate of good outcome (OR 0.092, 95% CI 0.023-0.360; p = 0.001), and a higher rate of mortality (OR 5.373, 95% CI 2.055-14.052; p = 0.001) at the 90-day follow-up. CONCLUSIONS MCE is not uncommon in BAO patients undergoing EVT and is associated with poor outcomes. Baseline GCS score and the number of procedures were predictors of MCE. In clinical practice, it is crucial that physicians identifying MCE after EVT in patients with BAO and identification of MCE will help in the selection of an appropriate pharmacological treatment strategy and close monitoring.
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Affiliation(s)
- Xianjun Huang
- 1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China
| | - Hao Wang
- 2Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
| | - Yachen Ji
- 1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China
| | - Chunrong Tao
- 3Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China; and
| | - Xianjin Shang
- 1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China
| | - Chuyuan Ni
- 4Department of Neurology, Huangshan City People's Hospital, Huangshan, Anhui, China
| | - Junfeng Xu
- 1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China
| | - Xiangjun Xu
- 1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China
| | - Wei Hu
- 3Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China; and
| | - Zhiming Zhou
- 1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, China
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Wei Y, Zhang Q, Niu J, Miao J, Ma R, Huo K, Wang S. Enlarged perivascular spaces predict malignant cerebral edema after acute large hemispheric infarction. Cerebrovasc Dis Extra 2024; 14:000536592. [PMID: 38316113 PMCID: PMC10927297 DOI: 10.1159/000536592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/26/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION Enlarged perivascular spaces (EPVS) are considered early manifestations of impaired clearance mechanisms in the brain; however, it is unclear whether EPVS they are associated with the development of malignant cerebral edema (MCE) after large hemispheric infarction (LHI). Therefore, we investigated the predictive value of EPVS in predicting MCE in LHI. METHODS Patients suffering from acute LHI were consecutively enrolled. EPVS were rated after the stroke with validated rating scales from magnetic resonance imagess. Patients were divided into two groups according to the occurrence of MCE. Logistic regression was used to analyze the relationship between EPVS and MCE in the basal ganglia (BG) and centrum semiovale (CS) regions. Receiver operating characteristic (ROC) curves assessed the ability of EPVS individually and with other factors in predicting MCE. RESULTS We included a total of 255 patients, of whom 98 were MCE patients (58 [59.2%] males, aged 70 [range=61.75-78] years) and found that atrial fibrillation, National Institutes of Health Stroke Scale score, infarct volume, neutrophil-lymphocyte ratio, and moderate-to-severe CS-EPVS were positively associated with MCE. After adjusting for confounds, moderate-to-severe CS-EPVS remained independent risk factor of MCE (odds ratio=16.212, p<0.001). According to the ROC analysis, MCE was highly suspected when CS-EPVS > 14 (sensitivity=0.82, specificity=0.48), and the guiding value were higher when CS-EPVS combined with other MCE predictors (area under the curve=0.90, sensitivity=0.74, specificity=0.90). CONCLUSION CS-EPVS were important risk factor for MEC in patients with acute LHI and can help identify patients at risk for MCE.
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Affiliation(s)
- Yaxin Wei
- School of Clinical Medicine, Yan’an University, Yan’an, China
- Department of Neurology, Yan’an University Affiliated Xianyang Hospital, Xianyang, China
| | - Qingzi Zhang
- Department of Neurology, Yan’an University Affiliated Xianyang Hospital, Xianyang, China
| | - Jinhui Niu
- School of Clinical Medicine, Yan’an University, Yan’an, China
| | - Jian Miao
- Department of Neurology, Yan’an University Affiliated Xianyang Hospital, Xianyang, China
| | - Rui Ma
- School of Clinical Medicine, Yan’an University, Yan’an, China
| | - Kang Huo
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Shaojun Wang
- Department of Neurology, Yan’an University Affiliated Xianyang Hospital, Xianyang, China
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Xie W, Ma X, Xu G, Wang Y, Huang W, Liu M, Sheng S, Yuan J, Wang J. Development and validation of a nomogram for the risk prediction of malignant cerebral edema after acute large hemispheric infarction involving the anterior circulation. Front Neurol 2023; 14:1221879. [PMID: 37780698 PMCID: PMC10538642 DOI: 10.3389/fneur.2023.1221879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/18/2023] [Indexed: 10/03/2023] Open
Abstract
Background Malignant cerebral edema (MCE) is a life-threatening complication of large hemisphere infarction (LHI). Therefore, a fast, accurate, and convenient tool for predicting MCE can guide triage services and facilitate shared decision-making. In this study, we aimed to develop and validate a nomogram for the early prediction of MCE risk in acute LHI involving the anterior circulation and to understand the potential mechanism of MCE. Methods This retrospective study included 312 consecutive patients with LHI from 1 January 2019 to 28 February 2023. The patients were divided into MCE and non-MCE groups. MCE was defined as an obvious mass effect with ≥5 mm midline shift or basal cistern effacement. Least absolute shrinkage and selection operator (LASSO) and logistic regression were performed to explore the MCE-associated factors, including medical records, laboratory data, computed tomography (CT) scans, and independent clinic risk factors. The independent factors were further incorporated to construct a nomogram for MCE prediction. Results Among the 312 patients with LHI, 120 developed MCE. The following eight factors were independently associated with MCE: Glasgow Coma Scale score (p = 0.007), baseline National Institutes of Health Stroke Scale score (p = 0.006), Alberta Stroke Program Early CT Score (p < 0.001), admission monocyte count (p = 0.004), white blood cell count (p = 0.002), HbA1c level (p < 0.001), history of hypertension (p = 0.027), and history of atrial fibrillation (p = 0.114). These characteristics were further used to establish a nomogram for predicting prognosis. The nomogram achieved an AUC-ROC of 0.89 (95% CI, 0.82-0.96). Conclusion Our nomogram based on LASSO-logistic regression is accurate and useful for the early prediction of MCE after LHI. This model can serve as a precise and practical tool for clinical decision-making in patients with LHI who may require aggressive therapeutic approaches.
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Affiliation(s)
- Wei Xie
- Department of Neurology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
| | - Xiaoming Ma
- North China University of Science and Technology, Tangshan, China
| | - Geman Xu
- Department of Neurology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, China
| | - Yumei Wang
- Department of Neurology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
| | - Wendie Huang
- Department of Neurology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
| | - Meng Liu
- Department of Neurology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
| | - Shiying Sheng
- Department of Neurology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
| | - Jie Yuan
- Institution of Mental Health, North China University of Science and Technology, Tangshan, China
- Jitang College, North China University of Science and Technology, Tangshan, China
| | - Jing Wang
- Clinical Department, Tangshan Vocational and Technical College, Tangshan, China
- Tangshan Union Medical College Hospital, Tangshan, China
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Wen X, Hu X, Xiao Y, Chen J. Radiomics analysis for predicting malignant cerebral edema in patients undergoing endovascular treatment for acute ischemic stroke. Diagn Interv Radiol 2023; 29:402-409. [PMID: 36988060 PMCID: PMC10679706 DOI: 10.4274/dir.2023.221764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/02/2023] [Indexed: 02/19/2023]
Abstract
PURPOSE Radiomics analysis is a promising image analysis technique. This study aims to extract a radiomics signature from baseline computed tomography (CT) to predict malignant cerebral edema (MCE) in patients with acute anterior circulation infarction after endovascular treatment (EVT). METHODS In this retrospective study, 111 patients underwent EVT for acute ischemic stroke caused by middle cerebral artery (MCA) and/or internal carotid artery occlusion. The participants were randomly divided into two datasets: the training set (n = 77) and the test set (n = 34). The clinico-radiological profiles of all patients were collected, including cranial non-contrast-enhanced CT, CT angiography, and CT perfusion. The MCA territory on non-contrast-enhanced CT images was segmented, and the radiomics features associated with MCE were analyzed. The clinico-radiological parameters related to MCE were also identified. In addition, a routine visual radiological model based on radiological factors and a combined model comprising radiomics features and clinico-radiological factors were constructed to predict MCE. RESULTS The areas under the curve (AUCs) of the radiomics signature for predicting MCE were 0.870 (P < 0.001) and 0.837 (P = 0.002) in the training and test sets, respectively. The AUCs of the routine visual radiological model were 0.808 (P < 0.001) and 0.813 (P = 0.005) in the training and test sets, respectively. The AUCs of the model combining the radiomics signature and clinico-radiological factors were 0.924 (P < 0.001) and 0.879 (P = 0.001) in the training and test sets, respectively. CONCLUSION A CT image-based radiomics signature is a promising tool for predicting MCE in patients with acute anterior circulation infarction after EVT. For clinicians, it may assist in diagnostic decision-making.
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Affiliation(s)
- Xuehua Wen
- Department of Radiology, Center for Rehabilitation Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Zhejiang, China
| | - Xingfei Hu
- Department of Radiology, The First People’s Hospital of Daishan, Zhejiang, China
| | - Yanan Xiao
- Department of Radiology, Center for Rehabilitation Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Zhejiang, China
| | - Junfa Chen
- Department of Radiology, Center for Rehabilitation Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Zhejiang, China
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Christianson D, Seaman SC, Ray E, Li L, Zanaty M, Lemoine P, Wilson G, Grimm D, Park BJ, Gold C, Andrews B, Grady S, Dlouhy K, Howard MA 3rd. The Adjustable Cranial Plate (ACP): A novel implant designed to eliminate the need for cranioplasty surgery following a hemicraniectomy operation. World Neurosurg 2023:S1878-8750(23)00184-5. [PMID: 36804433 DOI: 10.1016/j.wneu.2023.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Decompressive hemicraniectomy (DHC) is performed to relieve life-threatening intracranial pressure elevations. After swelling abates, a cranioplasty is performed for mechanical integrity and cosmesis. Cranioplasty is costly with high complication rates. Prior attempts to obviate second stage cranioplasty have been unsuccessful. The Adjustable Cranial Plate (ACP) is designed for implantation during DHC to afford maximal volumetric expansion with later repositioning without requiring a second major operation. METHODS The ACP has a mobile section held by a tripod fixation mechanism. Centrally located gears adjust the implant between the UP and DOWN positions. Cadaveric ACP implantation was performed. Virtual DHC and ACP placement was done using imaging data from 94 patients who had previously undergone a DHC procedure to corroborate our cadaveric results. Imaging analysis methods were used to calculate volumes of cranial expansion. RESULTS The ACP implantation and adjustment procedures are feasible in cadaveric testing without wound closure difficulties. The results of the cadaveric study showed total volumetric expansion achieved was 222cm3. Results of the virtual DHC procedure show the volume of cranial expansion achieved by removing a standardized bone flap is 132cm3 (range 89-171cm3). Applied to virtual craniectomy patients, the total volume of expansion achieved with the ACP implantation operation was 222cm3 (range 181-263cm3). CONCLUSION ACP implantation during DHC procedure is technically feasible. It achieves a volume of cranial expansion that will accommodate that observed following survivable HC operations. Moving the implant from the UP to the DOWN position can easily be performed as a simple outpatient or in-patient bedside procedure, thus potentially eliminating second-stage cranioplasty procedures.
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Wang S, Luan Y, Peng T, Wang G, Zhou L, Wu W. Malignant cerebral edema after cranioplasty: a case report and literature review. Brain Inj 2023; 37:1-7. [PMID: 36625002 DOI: 10.1080/02699052.2023.2165157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 09/29/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Cranioplasty is a common surgery in the neurosurgery for patients with skull defects following decompression craniectomy. Concomitant rare complications are increasingly reported, such as malignant cerebral edema after cranioplasty. CASE REPORT A 45-year-old man underwent decompression craniectomy due to traumatic brain injury. At 3 months after the decompression craniectomy, the patient developed refractory subdural hydrogen and received ipsilateral refractory subdural effusion capsule resection, but no significant relief was seen. Therefore, the cranioplasty was decided to treat subdural hydrogen and restore the normal appearance of the skull. After the successful cranioplasty surgery and the expected anesthesia recovery period, the pupils of the patients were continued to be dilated and fixed, without light reflection and spontaneous breathing. The Computed Tomography of the patient 1 hour after surgery showed malignant cerebral edema. CONCLUSIONS Malignant cerebral edema is a rare and lethal complication after cranioplasty. Negative pressure drainage and deregulation of cerebral blood flow at the end of cranioplasty may partially explain the malignant cerebral after cranioplasty. In addition, patients with epileptic seizures, no spontaneous breathing, dilated pupils without reflection, and hypotension within a short period after cranioplasty may show the occurrence of malignant cerebral.
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Affiliation(s)
- Shaoxiong Wang
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, China
| | - Yongxin Luan
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, China
| | - Tao Peng
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, China
| | - Guangming Wang
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, China
| | - Lixiang Zhou
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, China
| | - Wei Wu
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, China
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Oravec CS, Tschoe C, Fargen KM, Kittel CA, Spiotta A, Almallouhi E, Starke RM, McCarthy DJ, Simon S, Zyck S, Gould GC, De Leacy R, Mocco J, Siddiqui A, Vaziri S, Fox WC, Fraser JF, Chitale R, Zipfel G, Huguenard A, Wolfe SQ. Trends in mechanical thrombectomy and decompressive hemicraniectomy for stroke: A multicenter study. Neuroradiol J 2021; 35:170-176. [PMID: 34269121 DOI: 10.1177/19714009211030526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Acute ischemic stroke has increasingly become a procedural disease following the demonstrated benefit of mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) on clinical outcomes and tissue salvage in randomized trials. Given these data and anecdotal experience of decreased numbers of decompressive hemicraniectomies (DHCs) performed for malignant cerebral edema, we sought to correlate the numbers of strokes, thrombectomies, and DHCs performed over the timeline of the 2013 failed thrombolysis/thrombectomy trials, to the 2015 modern randomized MT trials, to post-DAWN and DEFUSE 3. MATERIALS AND METHODS This is a multicenter retrospective compilation of patients who presented with ELVO in 11 US high-volume comprehensive stroke centers. Rates of tissue plasminogen activator (tPA), thrombectomy, and DHC were determined by current procedural terminology code, and specificity to acute ischemic stroke confirmed by each institution. Endpoints included the incidence of stroke, thrombectomy, and DHC and rates of change over time. RESULTS Between 2013 and 2018, there were 55,247 stroke admissions across 11 participating centers. Of these, 6145 received tPA, 4122 underwent thrombectomy, and 662 patients underwent hemicraniectomy. The trajectories of procedure rates over time were modeled and there was a significant change in MT rate (p = 0.002) without a concomitant change in the total number of stroke admissions, tPA administration rate, or rate of DHC. CONCLUSIONS This real-world study confirms an increase in thrombectomy performed for ELVO while demonstrating stable rates of stroke admission, tPA administration and DHC. Unlike prior studies, increasing thrombectomy rates were not associated with decreased utilization of hemicraniectomy.
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Affiliation(s)
- Chesney S Oravec
- Department of Neurosurgery, Wake Forest Baptist Medical Center, USA
| | - Christine Tschoe
- Department of Neurosurgery, Wake Forest Baptist Medical Center, USA
| | - Kyle M Fargen
- Department of Neurosurgery, Wake Forest Baptist Medical Center, USA
| | - Carol A Kittel
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Justin F Fraser
- Departments of Neurological Surgery, Neurology, Radiology, and Neuroscience, University of Kentucky, USA
| | | | | | | | - Stacey Q Wolfe
- Department of Neurosurgery, Wake Forest Baptist Medical Center, USA
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Fu B, Qi S, Tao L, Xu H, Kang Y, Yao Y, Yang B, Duan Y, Chen H. Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke. Front Neurol 2021; 11:609747. [PMID: 33424759 PMCID: PMC7786250 DOI: 10.3389/fneur.2020.609747] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022] Open
Abstract
Malignant cerebral edema (MCE) after an ischemic stroke results in a poor outcome or death. Early prediction of MCE helps to identify subjects that could benefit from a surgical decompressive craniectomy. Net water uptake (NWU) in an ischemic lesion is a predictor of MCE; however, CT perfusion and lesion segmentation are required. This paper proposes a new Image Patch-based Net Water Uptake (IP-NWU) procedure that only uses non-enhanced admission CT and does not need lesion segmentation. IP-NWU is calculated by comparing the density of ischemic and contralateral normal patches selected from the middle cerebral artery (MCA) area using standard reference images. We also compared IP-NWU with the Segmented Region-based NWU (SR-NWU) procedure in which segmented ischemic regions from follow-up CT images are overlaid onto admission images. Furthermore, IP-NWU and its combination with imaging features are used to construct predictive models of MCE with a radiomics approach. In total, 116 patients with an MCA infarction (39 with MCE and 77 without MCE) were included in the study. IP-NWU was significantly higher for patients with MCE than those without MCE (p < 0.05). IP-NWU can predict MCE with an AUC of 0.86. There was no significant difference between IP-NWU and SR-NWU, nor between their predictive efficacy for MCE. The inter-reader and interoperation agreement of IP-NWU was exceptional according to the Intraclass Correlation Coefficient (ICC) analysis (inter-reader: ICC = 0.92; interoperation: ICC = 0.95). By combining IP-NWU with imaging features through a random forest classifier, the radiomics model achieved the highest AUC (0.96). In summary, IP-NWU and radiomics models that combine IP-NWU with imaging features can precisely predict MCE using only admission non-enhanced CT images scanned within 24 h from onset.
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Affiliation(s)
- Bowen Fu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Shouliang Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.,Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
| | - Lin Tao
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
| | - Haibin Xu
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
| | - Yan Kang
- College of Health Science and Environment Engineering, Shenzhen Technology University, Shenzhen, China
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Benqiang Yang
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Yang Duan
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Huisheng Chen
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ, United States
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Tsarenko SV, Dzyadz'ko AM, Rybalko SS. [Glibenclamide as a promising agent for prevention and treatment of cerebral edema]. Zh Vopr Neirokhir Im N N Burdenko 2017; 81:88-93. [PMID: 28665392 DOI: 10.17116/neiro201781388-93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The article presents a review of the literature on the use of a fundamentally new technique for prevention and treatment of cerebral edema. A drug glibenclamide, which is used to treat type 2 diabetes mellitus, is able to reduce cerebral edema and neuronal damage as evidenced by the results of preclinical trials in rodents and the first results of drug application in patients. The article describes the mechanism of glibenclamide action and discusses the potential for its application.
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Affiliation(s)
- S V Tsarenko
- Treatment and Rehabilitation Center, Moscow, Russia
| | - A M Dzyadz'ko
- Republican Scientific and Practical Center of Organ and Tissue Transplantation, Minsk, Republic of Belarus
| | - S S Rybalko
- Republican Scientific and Practical Center of Neurology and Neurosurgery, Minsk, Republic of Belarus
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