Anterior Temporal Artery Sign in CT Angiography Predicts Reduced Fatal Brain Edema and Mortality in Acute M1 Middle Cerebral Artery Occlusions

作者：Menon Bijoy K^*; Bal Simerpreet; Modi Jayesh; Sohn Sung Il; Watson Timothy W J; Hill Michael D; Demchuk Andrew M; Goyal Mayank

来源：Journal of Neuroimaging, 2012, 22(2): 145-148.

DOI：10.1111/j.1552-6569.2010.00566.x

• Anterior temporal artery
• malignant MCA infarction
• mortality

BACKGROUND Mortality in acute ischemic middle cerebral artery (MCA) stroke ranges from 5% to 45%. We identify a vascular imaging sign, presence of %26quot;prominent anterior temporal artery%26quot; on computed tomography (CT) angiography (CTA) and investigate whether it predicts mortality in acute M1-MCA occlusions. %26lt;br%26gt;METHODS One hundred and two patients with acute M1-MCA occlusions from 2003-to 2007 were included in the study. A prominent anterior temporal artery arising from proximal M1 MCA was identified by two readers blinded to clinical outcome. Primary clinical outcome was survival (modified Rankin Scale [mRS] 0-5) at 3 months. %26lt;br%26gt;RESULTS An anterior temporal artery arising from M1 MCA was present in 20/102 (20%). Eighteen of 20 (90%) patients with this sign survived at 3 months (mRS 0-5) when compared to 66/82 (80.4%) patients without the sign (odds ratio 2.2 CI95.5-10.4). The sign has a sensitivity of 21% (CI95.13-. 25) but specificity of 89% (CI95.64-. 98) in predicting survival at 3 months. Positive predictive value was 90% with likelihood ratio of 1.9 (CI95.9-7.6). %26lt;br%26gt;CONCLUSION Presence of prominent anterior temporal artery in M1-MCA occlusions on CTA identifies a group of patients with reduced case fatality. The mechanism is likely related to a reduced chance of malignant cerebral edema.

• 出版日期2012-4