Enlarged Perivascular Spaces Predict Malignant Cerebral Edema after Acute Large Hemispheric Infarction

Abstract: Introduction: Enlarged perivascular spaces (EPVS) are considered early manifestations of impaired clearance mechanisms in the brain; however, it is unclear whether EPVS are associated with the development of malignant cerebral edema (MCE) after large hemispheric infarction (LHI). Therefore, we investigated the predictive value of EPVS in predicting MCE in LHI. Methods: Patients suffering from acute LHI were consecutively enrolled. EPVS were rated after the stroke with validated rating scales from magnetic resonance images. Patients were divided into two groups according to the occurrence of MCE. Logistic regression was used to analyze the relationship between EPVS and MCE in the basal ganglia (BG) and centrum semiovale (CS) regions. Receiver operating characteristic (ROC) curves assessed the ability of EPVS individually and with other factors in predicting MCE. Results: We included a total of 255 patients, of whom 98 were MCE patients (58 [59.2%] males, aged 70 [range = 61.75–78] years) and found that atrial fibrillation, National Institutes of Health Stroke Scale score, infarct volume, neutrophil-lymphocyte ratio, and moderate-to-severe CS-EPVS were positively associated with MCE. After adjusting for confounds, moderate-to-severe CS-EPVS remained independent risk factor of MCE (odds ratio = 16.212, p < 0.001). According to the ROC analysis, MCE was highly suspected when CS-EPVS >14 (sensitivity = 0.82, specificity = 0.48), and the guiding value was higher when CS-EPVS combined with other MCE predictors (area under the curve = 0.90, sensitivity = 0.74, specificity = 0.90). Conclusion: CS-EPVS were important risk factor for MEC in patients with acute LHI and can help identify patients at risk for MCE.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Enlarged Perivascular Spaces Predict Malignant Cerebral Edema after Acute Large Hemispheric Infarction ; volume:14 ; number:1 ; year:2024 ; pages:30-38 ; extent:9 ; Cerebrovascular diseases / Extra. Extra ; 14, Heft 1 (2024), 30-38 (gesamt 9)

Contributors, Places and Time

• Creator: Wei, Yaxin ; Zhang, Qingzi ; Niu, Jinhui ; Miao, Jian ; Ma, Rui ; Huo, Kang ; Wang, Shaojun

Further information

• DOI: 10.1159/000536592
• URN: urn:nbn:de:101:1-2412252328244.098159529727
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:26 AM CEST