Computed Tomographic Parameters Predicting Neurological Deterioration in Patients with Middle Cerebral Artery Territory Infarction
نویسنده
چکیده
Background: Large middle cerebral artery (MCA) infarcts may be complicated by and life-threatening brain edema. Objective: To identify brain computed tomographic (CT) findings that can predict neurologic deterioration in patients with large middle cerebral artery (MCA) territory infarctions. Neurological deterioration was defined as progressive drowsiness or signs of brain herniation. Patients and Methods: we prospectively studied 40 patients (22 males and 18 female) with large MCA occlusion admitted in stroke unit, Zagazig University Hospitals, during period from January 2006 to January 2009. Radiographic features reviewed included hyperdense middle cerebral artery sign (HMCAS), hypodensity of whole MCA territory, sulcal effacement, loss of lentiform nucleus or insular ribbon, and septal and pineal shift. Results: There were no demographic differences between deteriorated and non deteriorated group. Early (<12 hours) hypodensity of the whole MCA territory and the HMCAS at any time were independent predictors of neurologic deterioration. Conclusion: The HMCAS and early CT evidence of hypodensity of whole MCA territory are predictive of neurologic deterioration in patients with large MCA infarcts. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(4): 563-568]
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