Background And Purpose: Life threatening middle cerebral artery infarction [MCAI] occurs in about 10% of all stroke patients . The main cause of death in these cases is severe brain edema.
This leads to raised intracranial pressure, coma and death. Malignant Middle Cerebral Artery Infarction [MMCAI] patients characterized by parenchymal hypodensity in cranial computed tomography [CT] exceeding 50% of the MCA territory, the mortality rate is about 80% in such cases. Our study is primarily designed to identify clinical and radiological predictors that may reliably be used to discriminate MMCAI from non MMCAI cases and to evaluate the risk of MMCAI on the patient's outcome Patients And Methods: This study was conducted on30 patients with acute MCAL Their age ranged from 25-85 years with mean age of 60.87+/-14.52. years, 13 were males [43.3%] and 17 were females [56.7%] . All patients were subjected to general and neurological examination and assessed clinically according to the Canadian Neurological Scale [CA. NS] , then followed up for one month to determine the outcome. CT scanning was done within 48 hours after the stroke onset for all patients for defecate MMCAI from non MCAI
Results: MMCAI was detected in 13patients [43.33%] with a mean age of 62.31+/-12.57year. it highly occurred in right side lesions, [52.9%] , hypertensive [58.8%] , diabetic [62.5%] patients.7patients [53.85%] had progressive course and there was a significant deterioration in thierCA. N. S2 [p<0.01] . RadiologicaIly They had a significant [p<0.05] number of Attenuated Cortico-Meddullary Contrast [ACMA] [92.3%] , Hypodense Middle Cerebral Artery Sign [HMCAS] [61.5%] and non-significant [p>0.05] higher mass effect [76, 9%] . As regards the outcome MMCAI patients had a significantly [p<0.01] higher mortality [84.6%] . which occurred in older patients with mean a age of 63.54+/-14.23 year, males [76.9%] , hypertensives [64.7%] , and with right side lesions [58.82%] and significant [p<0.05] number of mass effect [80%] in their CT Conclusions: For improving the prognosis of MMCAI clinical and neuroradiological data within the first few hours after the onset of symptoms most be clarified for identification of MMCAI patients from non-MMCAI aiming to aggressive therapeutic strategies
Ahmed Diaa EL Din EL Anwar ,Ahmed Diaa EL Din EL Anwar ,Magdi Heram AL Ghamrawy ,Amaal Salah EL Din Motayam ,Wafaa Samir Hassan ,
Malignant middle cerebral artery infarction, early predictors and outcome,
Zagazig Univ. Med. J. 2003;
404-420 Views : 0