The DASH score: A simple score to assess risk for development of malignant middle cerebral artery infarction

Shimoyama, Takashi; Kimura, Kazumi; Uemura, Junichi; Yamashita, Shinji; Saji, Naoki; Shibazaki, Kensaku; Iguchi, Yasuyuki

doi:10.1016/j.jns.2013.12.024

Cited by 53 publications

(66 citation statements)

References 24 publications

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“…Baseline blood glucose was an independent predictor for CED development in our study, including severe edema, as was indicated but not statistically significantly associated in some earlier studies. 12,28,29 One explanation for this may be an impaired blood-brain barrier caused by high levels of glucose. 30 Level of consciousness has been found to be an independent predictor of all types of CED.…”

Section: 23mentioning

confidence: 99%

Predictors for Cerebral Edema in Acute Ischemic Stroke Treated With Intravenous Thrombolysis

Thorén

Azevedo

Dawson

et al. 2017

Stroke

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Thorén, M. et al. (2017) Predictors for cerebral edema in acute ischemic stroke treated with intravenous thrombolysis. Stroke, 48(9), pp. 2464 -2471 . (doi:10.1161 This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/145896/ AbstractBackground -Cerebral edema (CED) is a severe complication of acute ischemic stroke.

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Section: 23mentioning

confidence: 99%

Predictors for Cerebral Edema in Acute Ischemic Stroke Treated With Intravenous Thrombolysis

Thorén

Azevedo

Dawson

et al. 2017

Stroke

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“…Meta-analysis attempts have been made difficult by large differences in inclusion criteria of these studies, different cutoffs for infarct size and perfusion area, and heterogeneity on midline shift measurements [37]. As expected, patients with life-threatening edema tend to have higher National Institute of Health Stroke Scale (NIHSS) scores on admission [6,34,[38][39][40][41], are younger [34,[40][41][42][43], and more often had combined occlusion of MCA and either internal carotid artery, anterior cerebral artery, or posterior cerebral artery [3,6,34,37,41,42,44]. Carotid occlusions with ipsilateral abnormal circle of Willis as well as marginal leptomeningeal collateral supply have also been suggested as risk factors [42].…”

Section: Predictors Of a Malignant Coursementioning

confidence: 91%

“…The middle cerebral artery (MCA) is involved in over half of all acute ischemic strokes (AIS) [2]. Large MCA strokes are relatively common with an incidence approaching 10 % of all supratentorial strokes [2,3], often resulting from thromboembolic occlusion of MCA trunk or distal internal carotid artery (ICA) [4][5][6]. Clinically, MCA syndromes typically include ipsilateral head and gaze preferences, profound contralateral sensorimotor deficits, contralateral neglect, and visual field deficits.…”

Section: Introductionmentioning

confidence: 99%

Malignant MCA Stroke: an Update on Surgical Decompression and Future Directions

Maciel

Sheth

2015

Curr Atheroscler Rep

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Despite a decline over the past decade in overall stroke mortality, hemispheric strokes retain a strikingly high mortality due to their potential for malignant edema and herniation. The pathogenesis of ischemic cerebral edema is steered by disruption of ionic homeostasis in the neurogliovascular unit. Significant effort has been made to identify potential medical therapies targeting edema formation with promising results. To date, decompressive craniectomy remains the therapy with the most robust impact on mortality. Historically, patient selection for surgical treatment of malignant supratentorial strokes has focused on a strict age cutoff and hemispheric dominance. Recent evidence supports a significant mortality benefit in elderly population, although the impact in morbidity is modest. Careful patient selection for surgical treatment in conjunction with comprehensive neurocritical care and inclusion of family in the educated decision making process remain the mainstay of care for such shattering disease.

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“…The first article discussed is an original paper from 2014 by Shimoyama et al [2]. The authors proposed a score (the DASH score) to assess the risk for development of MMI in large MCA infarctions.…”

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confidence: 99%