Related Experiment Video

Updated: Jul 14, 2025

Utilizing a Cranial Window to Visualize the Middle Cerebral Artery During Endothelin-1 Induced Middle Cerebral Artery Occlusion
07:43

Utilizing a Cranial Window to Visualize the Middle Cerebral Artery During Endothelin-1 Induced Middle Cerebral Artery Occlusion

Published on: February 22, 2013

15.0K

Prominent veins sign is associated with malignant cerebral edema after acute ischemic stroke

Ping Lu1, Lingyun Cui1, Xingquan Zhao1,2,3

  • 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.

Heliyon
|October 9, 2023
PubMed

Insights

Prominent veins sign (PVS-SWI) predicts malignant cerebral edema (MCE) in acute ischemic stroke patients with large infarcts. This imaging marker indicates increased MCE risk, suggesting a need for closer monitoring and interventions in affected individuals.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Medicine

Background:

  • Malignant cerebral edema (MCE) significantly increases mortality and disability in acute ischemic stroke (AIS).
  • Current MCE prediction relies heavily on infarct volume, with limited tools for early detection.
  • Prominent veins sign on susceptibility-weighted imaging (PVS-SWI) is a potential marker for severely impaired tissue perfusion.

Purpose of the Study:

  • To investigate the association between PVS-SWI and early-onset MCE in patients with acute ischemic stroke due to severe large arterial stenosis or occlusion (SLASO).
  • To evaluate PVS-SWI as a predictor for MCE and other adverse outcomes, including neurological worsening and mortality.

Main Methods:

  • Retrospective study of 157 AIS patients with SLASO (June 2018-June 2020).
  • ASPECTS score used to quantify PVS-SWI extent; a score of 4-10 defined a positive PVS-SWI group.
  • Primary outcome: MCE (neurological deterioration, midline shift >5mm). Secondary outcomes: NIHSS worsening (≥2 points), in-hospital death, 1-year mortality.
  • Logistic regression analysis performed to assess correlations.

Main Results:

  • 40 patients (25.5%) developed MCE.
  • PVS-SWI was significantly more prevalent in patients who developed MCE (75.0% vs 45.3%; P = 0.001).
  • Multivariate analysis revealed PVS-SWI as an independent predictor of MCE in patients with larger infarct sizes (OR: 4.00, 95%CI: 1.54-10.35, p = 0.004).
  • PVS-SWI also predicted NIHSS worsening (≥2) in patients with smaller infarct sizes (OR: 11.13, 95%CI: 2.26-54.89, p = 0.003).
  • No significant association found between PVS-SWI and mortality.

Conclusions:

  • PVS-SWI is a valuable imaging marker for predicting early-onset MCE in AIS patients with large infarcts.
  • The presence of PVS-SWI in patients with large infarcts suggests an elevated risk of MCE, potentially necessitating intensified monitoring and therapeutic interventions.
  • PVS-SWI may also indicate neurological worsening in patients with smaller infarcts, but it is not associated with mortality.
Keywords:
ASPECTSIschemic strokeMalignant cerebral edemaProminent veins sign

More Related Videos

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia09:35

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia

Published on: November 15, 2024

435
Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis06:45

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

13.6K

Related Concept Videos

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
13
Veins of Head and Neck01:19

Veins of Head and Neck

The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
2.0K
Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
12
Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
355
Varicose Veins I: Introduction01:26

Varicose Veins I: Introduction

Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...
9
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14