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Verfasst von:Thomalla, Götz [VerfasserIn]   i
 Hartmann, Frank [VerfasserIn]   i
 Jüttler, Eric [VerfasserIn]   i
 Singer, Oliver C. [VerfasserIn]   i
 Lehnhardt, Fritz-Georg [VerfasserIn]   i
 Köhrmann, Martin [VerfasserIn]   i
 Kersten, Jan Felix [VerfasserIn]   i
 Krützelmann, Anna [VerfasserIn]   i
 Humpich, Marek C. [VerfasserIn]   i
 Sobesky, Jan [VerfasserIn]   i
 Gerloff, Christian [VerfasserIn]   i
 Villringer, Arno [VerfasserIn]   i
 Fiehler, Jens [VerfasserIn]   i
 Neumann-Haefelin, Tobias [VerfasserIn]   i
 Schellinger, Peter [VerfasserIn]   i
 Röther, Joachim [VerfasserIn]   i
Titel:Prediction of malignant middle cerebral artery infarction by magnetic resonance imaging within 6 hours of symptom onset
Titelzusatz:a prospective multicenter observational study
Verf.angabe:Götz Thomalla, MD, Frank Hartmann, PhD, Eric Juettler, MD, Oliver C. Singer, MD, Fritz-Georg Lehnhardt, MD, Martin Köhrmann, MD, Jan F. Kersten, MSc, Anna Krützelmann, MD, Marek C. Humpich, MD, Jan Sobesky, MD, Christian Gerloff, MD,Arno Villringer, MD, PhD, Jens Fiehler, MD, Tobias Neumann-Haefelin, MD, Peter D. Schellinger, MD, and Joachim Röther, MD for the Clinical Trial Net of the German Competence Network Stroke
E-Jahr:2010
Jahr:23 September 2010
Umfang:11 S.
Fussnoten:Gesehen am 15.11.2023
Titel Quelle:Enthalten in: Annals of neurology
Ort Quelle:Hoboken, NJ : Wiley-Blackwell, 1977
Jahr Quelle:2010
Band/Heft Quelle:68(2010), 4 vom: Okt., Seite 435-445
ISSN Quelle:1531-8249
Abstract:Objective Early identification of patients at risk of space-occupying “malignant” middle cerebral artery (MCA) infarction (MMI) is needed to enable timely decision for potentially life-saving treatment such as decompressive hemicraniectomy. We tested the hypothesis that acute stroke magnetic resonance imaging (MRI) predicts MMI within 6 hours of stroke onset. Methods In a prospective, multicenter, observational cohort study patients with acute ischemic stroke and MCA main stem occlusion were studied by MRI including diffusion-weighted imaging (DWI), perfusion imaging (PI), and MR-angiography within 6 hours of symptom onset. Multivariate regression analysis was used to identify clinical and imaging predictors of MMI. Results Of 140 patients included, 27 (19.3%) developed MMI. The following parameters were identified as independent predictors of MMI: larger acute DWI lesion volume (per 1 ml odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.06; p < 0.001), combined MCA + internal carotid artery occlusion (5.38, 1.55-18.68; p = 0.008), and severity of neurological deficit on admission assessed by the National Institutes of Health Stroke Scale score (per 1 point 1.16, 1.00-1.35; p = 0.053). The prespecified threshold of a DWI lesion volume >82 ml predicted MMI with high specificity (0.98, 95% CI 0.94-1.00), negative predictive value (0.90, 0.83-0.94), and positive predictive value (0.88, 0.62-0.98), but sensitivity was low (0.52, 0.32-0.71). Interpretation Stroke MRI on admission predicts malignant course in severe MCA stroke with high positive and negative predictive value and may help in guiding treatment decisions, such as decompressive surgery. In a subset of patients with small initial DWI lesion volumes, repeated diagnostic tests are required. ANN NEUROL 2010
DOI:doi:10.1002/ana.22125
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1002/ana.22125
 Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ana.22125
 DOI: https://doi.org/10.1002/ana.22125
Datenträger:Online-Ressource
Sprache:eng
Bibliogr. Hinweis:Erscheint auch als : Druck-Ausgabe: Thomalla, Götz, 1973 - : Prediction of malignant middle cerebral artery infarction by magnetic resonance imaging within 6 hours of symptom onset. - 2010
K10plus-PPN:1870311361
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