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Related Experiment Video

Updated: May 24, 2026

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
06:29

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

A Location-Specific Hyperdense Area Score Predicts Severe Mass Effect after Thrombectomy.

SiShan Wen1, Hao Tang1, JiaNan Li2

  • 1Department of Medical Imaging, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, Jiangsu, China.

Neurocritical Care
|May 22, 2026
PubMed
Summary

A new hyperdense area (HDA) score identifies stroke patients at high risk for severe mass effect after thrombectomy. This tool aids early risk stratification and intensive care management.

Keywords:
CTEdemaHyperdense areasStrokeThrombectomy

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Last Updated: May 24, 2026

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The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
06:38

The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo

Published on: December 19, 2025

Area of Science:

  • Neurology
  • Radiology
  • Critical Care Medicine

Background:

  • Hyperdense areas (HDAs) on post-thrombectomy CT scans in large vessel occlusion stroke indicate blood-brain barrier injury.
  • These injuries can lead to malignant edema or hemorrhagic transformation, potentially causing life-threatening mass effect.
  • Severe mass effect often requires surgical intervention, such as decompressive craniectomy.

Purpose of the Study:

  • To develop and validate a location-specific HDA score for predicting severe mass effect after thrombectomy.
  • To improve risk stratification for patients with anterior circulation large vessel occlusion stroke.

Main Methods:

  • A multicenter retrospective study of 865 patients with HDAs on post-thrombectomy CT.
  • Developed a location-specific HDA score by including insula, subarachnoid, and ventricular compartments.
  • Validated predictive models using LASSO regression, internal bootstrapping, and external data.

Main Results:

  • The HDA score demonstrated a dose-response relationship with severe mass effect risk.
  • Scores ≤3 indicated low risk (<10%) of severe mass effect with high negative predictive value (88.8%).
  • An integrated model incorporating HDA features, glucose, NIHSS, and ASPECTS showed superior performance (AUC 0.801) compared to a clinical model (AUC 0.737).

Conclusions:

  • A location-specific HDA score effectively identifies patients at high risk for severe mass effect post-thrombectomy.
  • Integration into a clinical prediction model enhances risk stratification accuracy.
  • This tool can guide timely intensive care management for stroke patients.