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Background: To assess the predictive value of prognosis of different computed tomography (CT) features and National Institutes of Health Stroke Scale score (N IHSS) in acute extensive middle cerebral artery (MCA) infarct. Methods: Fifty fi ve patients with acute extensive MCA infarct had the CT performed within 24 hour s of the onset of symptoms. A total of 11 CT features were analysed. The age dis tribution, presence of risk factors, presence of individual CT feature, the tota l CT score, and the NIHSS were correlated with the 30 day mortality.Results: Sin gle explanatory variable analysis showed NIHSS, presence of midline shift, midli ne shift of more than 1 cm, extent of infarct, presence of hydrocephalus, efface ment of subarachnoid space/cella media, attenuation of corticomedullary differen tiation, and total CT score were associated with the 30 day mortality. Both exte nt of infarct >67%and attenuationof corticomedullary differentiation gave a sen sitivity and specificity of 93%and 95%, respectively, for the prediction of su rvival. Logistic regression analysis showed that the extent of infarct and NIHSS were the only independent predictors.Conclusions: CT features and admission NIH SS are important parameters for prediction of survival in extensive MCA infarct.
Background: To assess the predictive value of prognosis of different computed tomography (CT) features and National Institutes of Health Stroke Scale score (N IHSS) in acute extensive middle cerebral artery (MCA) infarct. Methods: Fifty fi ve patients with acute extensive MCA infarct had the CT performed within 24 hour s of the onset of symptoms. A total of 11 CT features were dissected. The age dis tribution, presence of risk factors, presence of individual CT feature, the tota l CT score, and the NIHSS were correlated with the 30-day mortality. Results: Sin gle explanatory variable analysis showed NIHSS, presence of midline shift, midli ne shift of more than 1 cm, extent of infarct, presence of hydrocephalus, efface mentality of subarachnoid space / cella media, attenuation of Both corticomedullary differen tiation, and total CT score were associated with the 30-day mortality. Both exte nt of infarct> 67% and attenuation of corticomedullary differentiation gave a senitivity and specificity of 93% a nd 95%, respectively, for the prediction of su rvival. Logistic regression analysis showed that the extent of infarct and NIHSS were the only independent predictors. Conclusions: CT features and admission NIH SS are important parameters for prediction of survival in extensive in MCA infarct.