Leveron&Nexovas
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 5689  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed5635    
    Printed151    
    Emailed2    
    PDF Downloaded119    
    Comments [Add]    

Recommend this journal

 

 ORIGINAL ARTICLE
Year : 2016  |  Volume : 64  |  Issue : 3  |  Page : 436--441

Clinical course, prognostic factors, and long-term outcomes of malignant middle cerebral artery infarction patients in the modern era


1 Department of Internal Medicine, Stroke and Neurodegenerative Diseases Research Unit, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
2 Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
3 Department of Community Medicine, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand

Correspondence Address:
Dr. Pornpatr A Dharmasaroja
Division of Neurology, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120
Thailand
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.181567

Rights and Permissions

Background: Recanalization therapies have been increasingly applied in clinical practice, which might change the outcomes of patients with large middle cerebral artery (MCA) infarction. The purpose of this study was to study the clinical course, prognostic factors, and long-term outcomes of patients with an acute large MCA infarction. Methods: Patients with an acute large MCA infarction who were treated between January, 2011 – March, 2014 were studied. The demographics and vascular risk factors were compared between patients with and without clinical outcomes of interest, favorable outcome and death. Results: From a total of 1538 patients, 200 patients with large MCA infarction were included. The mean age was 67 years. The mean National Institute of Health Stroke Scale score was 20. The mean time from onset to the hospital was 289 min. Intravenous recombinant-tissue-plasminogen activator (rtPA) was given in 50 patients (25%). The mean follow-up time was 13 months. 51 patients (51/191, 27%) had a favorable outcome (modified Rankin Scale 0–2) at the final follow-up. 81 patients (81/191, 42%) died. A younger age, less severe stroke, rtPA treatment, and large-artery atherosclerosis stroke subtype were related to a favorable outcome. Older age and presence of coronary artery disease were associated with death and rtPA treatment was inversely related to death. Conclusions: Prognosis of patients with a large MCA infarction is still poor. Favorable outcomes were found in only a fourth of the total patients, and a high mortality rate was still present. Intravenous rtPA treatment seemed to be related to a favorable outcome.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 20th March '04
Published by Wolters Kluwer - Medknow