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 Volume 63, Number 11, December 14, 2004
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NEUROLOGY 2004;63:2142-2145
© 2004 American Academy of Neurology
Brief Communications

Which patient fares worse after early deterioration due to swelling from hemispheric stroke?

Boby V. Maramattom, MD, DM, Mark M. Bahn, MD and Eelco F.M. Wijdicks, MD

From the Division of Neurology Critical Care, Department of Neurology (Drs. Maramattom and Wijdicks), and the Division of Radiology (Dr. Bahn), Mayo Clinic, Rochester, MN.

Address correspondence and reprint requests to Dr. Eelco F.M. Wijdicks, Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55903; e-mail: wijde{at}mayo.edu

The authors studied 24 patients admitted to the neurointensive care unit because of clinical deterioration to drowsiness or stupor and midline shift after complete middle cerebral artery infarction (coMCAI) stroke. Fourteen (58%) experienced further deterioration and either underwent hemicraniectomy or refused surgery and died. These patients were significantly more likely to be female (72% vs 20%) and to have additional vascular territorial infarction (72% vs 0%) on initial CT. These features may help to identify patients at high risk for further deterioration after coMCAI.

Received January 8, 2004. Accepted in final form July 21, 2004.

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