Analysis of the risk factors for cerebral hernia in patients with large area infarction of middle cerebral artery
10.3969/j.issn.1672-5921.2011.10.005
- Author:
Dan SHI
1
Author Information
1. Department of Neurology
- Publication Type:Journal Article
- Keywords:
Brain edema;
Brain infarction;
Infarction, middle cerebral artery;
Risk factors
- From:
Chinese Journal of Cerebrovascular Diseases
2011;8(10):522-525
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the risk factors for fatal brain edema in patients with large area infarction of middle cerebral artery (malignant middle cerebral artery territory infarction, MMCI). Methods: The clinical data of 137 patients with MMCI from August 2002 to January 2011 were analyzed retrospectively. They were divided into brain hernia group (n = 48) and non-hernia group (n = 89) according to whether they had brain hernia or not in the course of disease. The possible risk factors for brain edema were analyzed. Results: Forty-six patients were died, 36 patients in the hernia group and 10 patients in the non-hernia group; 91 patients survived, but all left limb paralysis. Circled digit oneThe univariate analysis showed that the percentage of atrial fibrillation, staring, smoking, high systolic blood pressure, National Institutes of Health Stroke Scale (NIHSS) score and barthel index (BI) index in the hernia group were all higher than those in the non-hernia group. The differences were statistically significant (all P < 0.05); the Glasgow Coma Scale (GCS) score in the hernia group was lower than that in the non-hernia group (P < 0.01). Circled digit twoMultivariate logistic regression analysis showed that smoking (OR, 3.391; 95% CI, 1.339 to 30.505), GCS score (OR, 0.684, 95% CI, 0.554 to 0.844) and systolic blood pressure level (OR, 1.027, 95% CI, 1.006 to 1.049) were significantly correlated with the occurrence of brain edema. Conclusion: The patients with MMCI combined with atrial fibrillation are more susceptible to acute cerebral edema caused brain hernia. Smoking, GCS score and high systolic blood pressure level may be the risk factors for cerebral hernia.
