Document Detail

Midline-shift corresponds to the amount of brain edema early after hemispheric stroke--an MRI study in rats.
MedLine Citation:
PMID:  17413996     Owner:  NLM     Status:  MEDLINE    
Vasogenic brain edema formation is a serious complication in hemispheric stroke. Its space-occupying effect can lead to midline-shift (MLS), cerebral herniation, and death. Clinical studies indicate that quantification of MLS can predict cerebral herniation and subsequent death at early time-points, even before clinical deterioration becomes apparent. The present experimental study was designed to determine the relation between MLS, absolute edema volume, lesion size, and clinical findings in a rat stroke model. Middle cerebral artery-occlusion was performed in 24 rats using the suture technique. Clinical evaluation and magnetic resonance imaging (MRI) (Bruker PharmaScan 7.0T) was performed 24 hours later. Lesion volume, the volume-increase within the affected hemisphere (%HEV), and MLS were quantified on T2-weighted images. The absolute increase of hemispheric water content (DeltaH2O) was determined in a subgroup using the wet-dry method (n=12). MLS correlated significantly with the total amount of brain edema (magnetic resonance imaging study: r=0.82; P<0.01; wet-dry analysis r=0.80; P<0.01). MLS correlated only moderately with T2-lesion volume (r=0.55; P<0.01). No significant correlation could be detected between MLS and clinical scores (r=0.26; P>0.05). MLS thus quantitatively reflects the amount of vasogenic brain edema within the affected hemisphere at early time-points. MLS quantification can be regarded as an easily assessable and valid global quantitative parameter for brain edema and thus might facilitate the surgical and nonsurgical management of edema in acute stroke patients.
Maureen Walberer; Franz Blaes; Erwin Stolz; Clemens Müller; Markus Schoenburg; Marlene Tschernatsch; Georg Bachmann; Tibo Gerriets
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  19     ISSN:  0898-4921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-05-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
Department of Neurology, University Giessen, Giessen, Germany.
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MeSH Terms
Body Water / physiology
Brain Edema / etiology*,  pathology*
Consciousness / physiology
Functional Laterality / physiology
Intracranial Pressure / physiology
Locomotion / physiology
Magnetic Resonance Imaging
Middle Cerebral Artery / physiology
Neurologic Examination
Postural Balance / physiology
Stereotyped Behavior / physiology
Stroke / complications*,  pathology*

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