Prediction of Malignant Middle Cerebral Artery Infarction in Elderly Patients

Background We evaluated the clinical outcomes of malignant middle cerebral artery (MCA) infarction (MMI) and determined an infarcted brain volume (BV) threshold value for accurate MMI prediction in elderly patients. Methods We analyzed 69 consecutive patients (mean, 75.6 ± 11.7) with internal carotid artery or MCA infarction within 48 hours from onset. Diffusion-weighted high-intensity volume (DHV) and BV were measured in all patients. The percentage of DHV within BV (DHV/BV ratio) was calculated to standardize the DHV difference for each individual BV. Patients were stratified based upon their MMI status and age, compared with the following: (1) MMI versus non-MMI groups and (2) age ≥75 years group versus age Results The MMI group (n = 14) showed significantly larger DHV values ( P P P P 3 (sensitivity 85%, specificity 91%, P P Conclusions DHV and DHV/BV can provide reliable information for MMI prediction in elderly patients.