Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke
Malignant cerebral edema (MCE) is often associated with severe physical disability and a high mortality rate. The current prediction of MCE is focused on infarct volume, and tools are relatively lacking. The prominent veins sign (PVS-SWI) is considered a marker of severely impaired tissue perfusion....
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023069669 |
| _version_ | 1797669790188306432 |
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| author | Ping Lu Lingyun Cui Xingquan Zhao |
| author_facet | Ping Lu Lingyun Cui Xingquan Zhao |
| author_sort | Ping Lu |
| collection | DOAJ |
| description | Malignant cerebral edema (MCE) is often associated with severe physical disability and a high mortality rate. The current prediction of MCE is focused on infarct volume, and tools are relatively lacking. The prominent veins sign (PVS-SWI) is considered a marker of severely impaired tissue perfusion. This study aimed to determine whether PVS-SWI is associated with early-onset MCE. Patients with acute ischemic stroke (AIS) due to severe large arterial stenosis or occlusion (SLASO) from June 2018 to June 2020 were included. The ASPECTS score assessed the extent of PVS-SWI, and 4–10 was defined as a positive group. The primary outcome was MCE, defined as the deterioration of neurological function and midline structural excursions of >5 mm during hospitalization. The secondary outcomes included worsening of the NIHSS by ≥ 2 points, in-hospital death, and death within 1 year after stroke. Logistic regression was used to assess the correlation between PVS-SWI and outcomes. The study included 157 patients， 40 (25.5%) of whom developed MCE. PVS-SWI was more prevalent in patients who developed MCE (75.0% vs 45.3%; P = 0.001). In multivariate regression analysis, PVS-SWI was an independent predictor of MCE development in patients with larger infarct sizes (OR: 4.00， 95%CI: 1.54–10.35，p = 0.004). In patients with small infarct sizes, PVS-SWI was an independent predictor of a worsening NIHSS of ≥2(OR: 11.13， 95%CI: 2.26–54.89， p = 0.003）. However, PVS-SWI was not associated with death. The main finding of our study was that in patients with larger infarct sizes, a positive PVS-SWI increased the risk of developing MCE. In these patients, more interventions may be needed. |
| first_indexed | 2024-03-11T20:49:51Z |
| format | Article |
| id | doaj.art-bb718ee7ab6d43469a07528606437785 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-11T20:49:51Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-bb718ee7ab6d43469a075286064377852023-10-01T06:01:09ZengElsevierHeliyon2405-84402023-09-0199e19758Prominent veins sign is associated with malignant cerebral edema after acute ischemic strokePing Lu0Lingyun Cui1Xingquan Zhao2Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of ChinaDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People's Republic of China; Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; Corresponding author. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University,119#Nan Si Huan Xi Lu, Beijing, 100070, People's Republic of China.Malignant cerebral edema (MCE) is often associated with severe physical disability and a high mortality rate. The current prediction of MCE is focused on infarct volume, and tools are relatively lacking. The prominent veins sign (PVS-SWI) is considered a marker of severely impaired tissue perfusion. This study aimed to determine whether PVS-SWI is associated with early-onset MCE. Patients with acute ischemic stroke (AIS) due to severe large arterial stenosis or occlusion (SLASO) from June 2018 to June 2020 were included. The ASPECTS score assessed the extent of PVS-SWI, and 4–10 was defined as a positive group. The primary outcome was MCE, defined as the deterioration of neurological function and midline structural excursions of >5 mm during hospitalization. The secondary outcomes included worsening of the NIHSS by ≥ 2 points, in-hospital death, and death within 1 year after stroke. Logistic regression was used to assess the correlation between PVS-SWI and outcomes. The study included 157 patients， 40 (25.5%) of whom developed MCE. PVS-SWI was more prevalent in patients who developed MCE (75.0% vs 45.3%; P = 0.001). In multivariate regression analysis, PVS-SWI was an independent predictor of MCE development in patients with larger infarct sizes (OR: 4.00， 95%CI: 1.54–10.35，p = 0.004). In patients with small infarct sizes, PVS-SWI was an independent predictor of a worsening NIHSS of ≥2(OR: 11.13， 95%CI: 2.26–54.89， p = 0.003）. However, PVS-SWI was not associated with death. The main finding of our study was that in patients with larger infarct sizes, a positive PVS-SWI increased the risk of developing MCE. In these patients, more interventions may be needed.http://www.sciencedirect.com/science/article/pii/S2405844023069669Malignant cerebral edemaIschemic strokeProminent veins signASPECTS |
| spellingShingle | Ping Lu Lingyun Cui Xingquan Zhao Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke Heliyon Malignant cerebral edema Ischemic stroke Prominent veins sign ASPECTS |
| title | Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke |
| title_full | Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke |
| title_fullStr | Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke |
| title_full_unstemmed | Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke |
| title_short | Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke |
| title_sort | prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke |
| topic | Malignant cerebral edema Ischemic stroke Prominent veins sign ASPECTS |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023069669 |
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