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000019328 084__ $$2WoS$$aClinical Neurology
000019328 084__ $$2WoS$$aPeripheral Vascular Disease
000019328 1001_ $$0P:(DE-HGF)0$$aDohmen, C.$$b0
000019328 245__ $$aThe Severity of Ischemia Determines and Predicts Malignant Brain Edema in Patients with Large Middle Cerebral Artery Infarction
000019328 260__ $$aBasel$$bKarger$$c2012
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000019328 440_0 $$022882$$aCerebrovascular Disease$$v33$$y1
000019328 500__ $$aThis study was supported by the Federal Ministry of Education and Research (BMBF), Competence Network Stroke.
000019328 520__ $$aIn order to determine the impact of the severity of ischemia on malignant edema formation, we investigated various degrees of perfusional deficit by (11)C-flumazenil PET in patients with large middle cerebral artery (MCA) infarction.17 patients with large MCA stroke were included. Cerebral blood flow (CBF) was measured 15.9 ± 6.4 h after the ictus. Patients were divided into a malignant (n = 9) and a benign group (n = 8) as a function of their clinical courses and edema. Edema was measured as maximal midline shift on follow-up CTs. Total hypoperfusion volume was divided into different subvolumes according to the degree of CBF reduction.Subvolumes of severe ischemia relative to total ischemic area were significantly larger in the malignant group than in the benign group and were significantly correlated with edema formation. The highest correlation and best predictive values for edema formation with a sensitivity, specificity, and a positive and negative predictive value of 100% were found for subvolumes with severe ischemia. Correlation coefficients and prediction decreased for subvolumes with less severe perfusional deficit, pointing to the risk of misclassifying patients when relying on the volume of total perfusional deficit alone.Malignant MCA infarction seems to be determined more by the volume of severe perfusional deficit than that of total perfusional deficit. Assessment of severely ischemic areas allows prediction of malignant edema formation and might help to select candidates for hemicraniectomy.
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000019328 588__ $$aDataset connected to Web of Science, Pubmed
000019328 650_2 $$2MeSH$$aAged
000019328 650_2 $$2MeSH$$aBrain Edema: etiology
000019328 650_2 $$2MeSH$$aBrain Edema: physiopathology
000019328 650_2 $$2MeSH$$aBrain Edema: radiography
000019328 650_2 $$2MeSH$$aBrain Edema: surgery
000019328 650_2 $$2MeSH$$aCerebrovascular Circulation
000019328 650_2 $$2MeSH$$aChi-Square Distribution
000019328 650_2 $$2MeSH$$aDecompressive Craniectomy
000019328 650_2 $$2MeSH$$aFemale
000019328 650_2 $$2MeSH$$aFlumazenil: diagnostic use
000019328 650_2 $$2MeSH$$aGermany
000019328 650_2 $$2MeSH$$aHumans
000019328 650_2 $$2MeSH$$aInfarction, Middle Cerebral Artery: complications
000019328 650_2 $$2MeSH$$aInfarction, Middle Cerebral Artery: physiopathology
000019328 650_2 $$2MeSH$$aInfarction, Middle Cerebral Artery: radionuclide imaging
000019328 650_2 $$2MeSH$$aInfarction, Middle Cerebral Artery: surgery
000019328 650_2 $$2MeSH$$aMale
000019328 650_2 $$2MeSH$$aMiddle Aged
000019328 650_2 $$2MeSH$$aPatient Selection
000019328 650_2 $$2MeSH$$aPerfusion Imaging: methods
000019328 650_2 $$2MeSH$$aPositron-Emission Tomography
000019328 650_2 $$2MeSH$$aPredictive Value of Tests
000019328 650_2 $$2MeSH$$aPrognosis
000019328 650_2 $$2MeSH$$aRadiopharmaceuticals: diagnostic use
000019328 650_2 $$2MeSH$$aRisk Assessment
000019328 650_2 $$2MeSH$$aRisk Factors
000019328 650_2 $$2MeSH$$aSensitivity and Specificity
000019328 650_2 $$2MeSH$$aSeverity of Illness Index
000019328 650_2 $$2MeSH$$aTime Factors
000019328 650_2 $$2MeSH$$aTomography, X-Ray Computed
000019328 650_7 $$00$$2NLM Chemicals$$aRadiopharmaceuticals
000019328 650_7 $$078755-81-4$$2NLM Chemicals$$aFlumazenil
000019328 650_7 $$2WoSType$$aJ
000019328 65320 $$2Author$$aBrain edema
000019328 65320 $$2Author$$aIschemic stroke
000019328 65320 $$2Author$$aMalignant infarction
000019328 65320 $$2Author$$aEmission tomography
000019328 7001_ $$0P:(DE-Juel1)VDB73298$$aGalldiks, N.$$b1$$uFZJ
000019328 7001_ $$0P:(DE-HGF)0$$aBosche, B.$$b2
000019328 7001_ $$0P:(DE-HGF)0$$aKracht, L.$$b3
000019328 7001_ $$0P:(DE-Juel1)VDB89964$$aGraf, R.$$b4$$uFZJ
000019328 773__ $$0PERI:(DE-600)1482069-9$$a10.1159/000330648$$gVol. 33, p. 1 - 7$$p1 - 7$$q33<1 - 7$$tCerebrovascular diseases$$v33$$x1015-9770$$y2012
000019328 8567_ $$uhttp://dx.doi.org/10.1159/000330648
000019328 8564_ $$uhttps://juser.fz-juelich.de/record/19328/files/FZJ-19328.pdf$$yPublished under German "Allianz" Licensing conditions on 2012-01-01. Available in OpenAccess from 2013-01-01$$zPublished final document.
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000019328 9141_ $$y2012
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