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Updated: Apr 21, 2026

Measuring Post-Stroke Cerebral Edema, Infarct Zone and Blood-Brain Barrier Breakdown in a Single Set of Rodent Brain Samples
Published on: October 23, 2020
Brain edema predicts outcome after nonlacunar ischemic stroke
Thomas W K Battey1, Mahima Karki1, Aneesh B Singhal1
1From the Center for Human Genetic Research (T.W.K.B., M.K., W.T.K.), Division of Neurocritical Care and Emergency Neurology (T.W.K.B., M.K., W.T.K.), J. Philip Kistler Stroke Research Center (T.W.K.B., M.K., A.B.S., O.W., S.S., W.T.K.), and Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology (O.W.), Massachusetts General Hospital, Boston; Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia (B.C.V.C., S.M.D.); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (B.C.V.C., G.A.D.); and Division of Neurocritical Care and Emergency Neurology, Yale New Haven Hospital, CT (K.N.S.).
Brain swelling and infarct growth significantly impact stroke outcomes. Swelling volume exceeding 11 mL is a key predictor of poor neurological outcomes in stroke patients.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Brain edema in malignant infarction correlates with poor neurological outcomes.
- Understanding swelling's role in smaller strokes is crucial for predicting patient prognosis.
Purpose of the Study:
- To investigate the association between brain swelling and clinical outcomes in acute stroke patients.
- To differentiate the impact of swelling versus infarct growth on stroke outcomes.
Main Methods:
- Analysis of two acute stroke cohorts using serial brain MRI.
- Assessment of swelling and infarct growth using diffusion-weighted imaging (DWI) and region-of-interest analysis.
- Evaluation of imaging markers' relationship with outcome via univariable and multivariable regression.
Main Results:
- Brain swelling independently predicted worse outcomes (OR, 4.55; P<0.02).
- Increased stroke volume (ΔDWI) correlated with poor outcomes (OR, 4.29; P<0.001).
- Volumetrically, swelling (OR, 1.09; P<0.005) and larger infarct growth (OR, 7.05; P<0.045) independently predicted poor outcomes.
Conclusions:
- Both swelling and infarct growth contribute to lesion expansion post-stroke.
- Brain swelling is an independent predictor of poor stroke outcomes.
- A brain swelling volume of ≥11 mL serves as a sensitive and specific threshold for predicting poor outcomes.
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