Jo et al reported a simple score for identifying a patient at risk for malignant brain edema. This can help to identify a patient who may benefit from more aggressive management. The authors are from The Catholic University of Korea and the University of Texas Houston.
Patient selection: large hemispheric infarction (ischemic stroke)
Parameters:
(1) ASPECTS (from 0 to 10)
(2) NIHSS score (from 0 to 42)
(3) collateral score (from 0 to 3)
(4) revascularization
Parameter
Finding
Points
ASPECTS
>= 8
0
<= 7
1
NIHSS score
0 to 8
0
9 to 17
1
>= 18
2
collateral score
2 or 3
0
0 or 1
2
revascularization
no
1
yes
0
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk for malignant brain edema.
Score
Percent with MBE
0 or 1
0%
2
12%
3
15%
4
37%
5
85%
6
100%
Performance:
• The area under the ROC curve is 0.88.
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