A patient with an ischemic stroke is at risk for malignant brain edema. Wu et al identified factors associated with its development. The presence of early predictors of edema may identify a patient who may benefit from more aggressive management. The authors are from Sichuan University in Chengdu, China.
Patient selection: ischemic stroke
Malignant brain edema shows a rapid neurological deterioration associated with massive cerebral swelling and transtentorial herniation.
Early predictors for malignant brain edema:
(1) younger age: using < 60 years (page 2919)
(2) higher NIHSS: using >=17 (page 2919)
(3) larger parenchymal hypoattenuation on admission CT scan (larger infarct volume): using > 145 cubic cm (page 2920)
Revascularization reduces the risk of malignant edema.
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