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Lesion volume, lesion location, and outcome after middle cerebral artery territory stroke

Lesion volume, lesion location, and outcome after middle cerebral artery territory stroke
Lesion volume, lesion location, and outcome after middle cerebral artery territory stroke

Aim - To investigate the relation between lesion volume, lesion location, and clinical outcome in children with infarction in the territory of the middle cerebral artery (MCA). Patients and methods - Children with MCA territory infarcts were selected retrospectively from a database of children with ischaemic stroke. Lesion volumes were expressed as a percentage of the supratentorial intracranial volume and were categorised as 'small', 'moderate', or 'large'. Lesion location was categorised as cortical or purely subcortical. Outcome was ascertained by parental questionnaire and was categorised as 'good' or 'poor'. Results - 38 patients were identified (median age 6 years); 21 patients had lesion that involved cortical tissues. Outcome was good in 12 cases and poor in 26 cases (including 2 children who died). Although there was no significant effect of lesion size or lesion location on outcome for the group as a whole, all children who had infarcted more than 10% of intracranial volume had a poor outcome. Of note, some children with small subcortical lesions had pronounced residual deficits. Conclusions - Although the outcome after a small infarct in the MCA territory is variable and unpredictable, infarction of more than 10% of intracranial volume is universally associated with a poor outcome. Characterisation of lesion volume and topography might be helpful in identification of such children for participation in future trials of treatments for acute stroke.

Intracranial volume, Outcome, Stroke
0003-9888
295-300
Ganesan, V.
0541b25d-409b-434a-b628-8df993f1d8c8
Ng, V.
c3c41fdf-5833-4774-aeef-d3b310b525b9
Chong, W.K.
bb7bc2ce-1866-4fb0-8b82-5a6d2381b67a
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Connelly, A.
0cb19e67-b09d-458b-8c30-1e9f8a279887
Ganesan, V.
0541b25d-409b-434a-b628-8df993f1d8c8
Ng, V.
c3c41fdf-5833-4774-aeef-d3b310b525b9
Chong, W.K.
bb7bc2ce-1866-4fb0-8b82-5a6d2381b67a
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Connelly, A.
0cb19e67-b09d-458b-8c30-1e9f8a279887

Ganesan, V., Ng, V., Chong, W.K., Kirkham, F.J. and Connelly, A. (1999) Lesion volume, lesion location, and outcome after middle cerebral artery territory stroke. Archives of Disease in Childhood, 81 (4), 295-300. (doi:10.1136/adc.81.4.295).

Record type: Article

Abstract

Aim - To investigate the relation between lesion volume, lesion location, and clinical outcome in children with infarction in the territory of the middle cerebral artery (MCA). Patients and methods - Children with MCA territory infarcts were selected retrospectively from a database of children with ischaemic stroke. Lesion volumes were expressed as a percentage of the supratentorial intracranial volume and were categorised as 'small', 'moderate', or 'large'. Lesion location was categorised as cortical or purely subcortical. Outcome was ascertained by parental questionnaire and was categorised as 'good' or 'poor'. Results - 38 patients were identified (median age 6 years); 21 patients had lesion that involved cortical tissues. Outcome was good in 12 cases and poor in 26 cases (including 2 children who died). Although there was no significant effect of lesion size or lesion location on outcome for the group as a whole, all children who had infarcted more than 10% of intracranial volume had a poor outcome. Of note, some children with small subcortical lesions had pronounced residual deficits. Conclusions - Although the outcome after a small infarct in the MCA territory is variable and unpredictable, infarction of more than 10% of intracranial volume is universally associated with a poor outcome. Characterisation of lesion volume and topography might be helpful in identification of such children for participation in future trials of treatments for acute stroke.

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More information

Published date: October 1999
Keywords: Intracranial volume, Outcome, Stroke

Identifiers

Local EPrints ID: 429813
URI: http://eprints.soton.ac.uk/id/eprint/429813
ISSN: 0003-9888
PURE UUID: dfeed615-d9b8-43e6-987f-2d327cc64a35
ORCID for F.J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 05 Apr 2019 16:30
Last modified: 07 Oct 2020 01:46

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