A simple prediction score system for malignant brain edema progression in large hemispheric infarction

作者：Jo KwangWook; Bajgur Suhas S; Kim Hoon; Choi Huimahn A; Huh Pil Woo; Lee Kiwon

来源：PLos One, 2017, 12(2): e0171425.

DOI：10.1371/journal.pone.0171425

Malignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at high risk for MBE. 121 patients with large hemispheric infarction (LHI) (2011 to 2014) were included. Patients were divided into two groups: those who developed MBE and those who did not. Independent predictors of MBE were identified by logistic regression and a score was developed. Four factors were independently associated with MBE: baseline National Institutes of Health Stroke Scale (NIHSS) score (p = 0.048), Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (p = 0.007), collateral score (CS) (p<0.001) and revascularization failure (p = 0.013). Points were assigned for each factor as follows: NIHSS <= 8 (= 0), 9-17 (= 1), >= 18 (= 2); ASPECTS <= 7 (= 1), >8 (= 0); CS<2 (= 1), >= 2 (= 0); revascularization failure (= 1), success (= 0). The MBE Score (MBES) represents the sum of these individual points. Of 26 patients with a MBES of 0 to 1, none developed MBE. All patients with a MBES of 6 developed MBE. Both MBE development and functional outcomes were strongly associated with the MBES (p = 0.007 and 0.002, respectively). The MBE score is a simple reliable tool for the prediction of MBE.

• 出版日期2017-2-8