Reinforce the awareness of prevention of critical cerebral infarction by categories and phases_West China Medical Journal

Authors：

GUO Wen , WU Simiao ,  LIU Ming

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LIU Ming, Email: wyplmh@hotmail.com

Keywords：

Critical cerebral infarction; Malignant brain edema; Massive cerebral infarction; Severe cerebral infarction; Prevention by categories and phases

DOI：

10.7507/1002-0179.202105120

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Massive and severe cerebral infarction can lead to a high mortality and disability rate, and it is the bottleneck of preventing and treating cerebrovascular disease. Once the malignant brain edema of massive cerebral infarction or the critical status of severe cerebral infarction occurs, the treatment effect is very poor. Therefore, we should not only focus on the treatment of critical cerebral infarction, but also prevent its occurrence. It is clinically important to prevent the occurrence of this critical condition in advance and to prevent the occurrence of massive cerebral infarction and severe cerebral infarction. This article points out that some patients with massive or severe cerebral infarction can be prevented from becoming critically ill. The definition, key risk factors and corresponding prevention and treatment strategies of critical cerebral infarction have also been proposed. Critical cerebral infarction can be divided into two categories with or without malignant brain edema, and the risk factors and prediction and prevention strategies by categories andphases can be studied separately.

Citation： GUO Wen, WU Simiao, LIU Ming. Reinforce the awareness of prevention of critical cerebral infarction by categories and phases. West China Medical Journal, 2021, 36(6): 701-706. doi: 10.7507/1002-0179.202105120 Copy

1.	Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405.
2.	Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
3.	Wang Y, Liao X, Zhao X, et al. Using recombinant tissue plasminogen activator to treat acute ischemic stroke in China: analysis of the results from the Chinese National Stroke Registry (CNSR). Stroke, 2011, 42(6): 1658-1664.
4.	王璐, 暢雪麗, 袁若圳, 等. 重癥腦梗死臨床特點及相關影響因素研究. 華西醫學, 2018, 33(6): 665-672.
5.	吳思緲, 吳波, 郭富強, 等. 重癥腦梗死優化診治方案及流程建議草案. 華西醫學, 2019, 34(10): 1096-1108.
6.	吳思緲, 袁若圳, 劉鳴. 應當提倡大面積腦梗死后惡性腦水腫的預防理念及其研究. 中華神經科雜志, 2020, 53(4): 244-249.
7.	郭睿, 于志淵, 吳思緲, 等. 大面積腦梗死惡性腦水腫外科減壓術規范化循證治療建議草案. 中國循證醫學雜志, 2021, 21(5): 503-513.
8.	Wu S, Yuan R, Wang Y, et al. Early prediction of malignant brain edema after ischemic stroke. Stroke, 2018, 49(12): 2918-2927.
9.	Volny O, Cimflova P, Lee TY, et al. Permeability surface area product analysis in malignant brain edema prediction - a pilot study. J Neurol Sci, 2017, 376: 206-210.
10.	Wang L, Guo W, Wang C, et al. Dynamic change of neutrophil to lymphocyte ratios and infection in patients with acute ischemic stroke. Curr Neurovasc Res, 2020, 17(3): 294-303.
11.	李昱曉, 周紅青, 劉鳴. 大面積腦梗死發生和預后相關因素研究. 華西醫學, 2018, 33(6): 684-690.
12.	Bai X, Wang C, Wang L, et al. Association between neutrophil to lymphocyte ratio and malignant brain edema in patients with large hemispheric infarction. Curr Neurovasc Res, 2020, 17(4): 429-436.
13.	Cheng Y, Wu S, Wang Y, et al. External validation and modification of the EDEMA score for predicting malignant brain edema after acute ischemic stroke. Neurocrit Care, 2020, 32(1): 104-112.
14.	Ong CJ, Gluckstein J, Laurido-Soto O, et al. Enhanced detection of Edema in Malignant Anterior Circulation Stroke (EDEMA) score: a risk prediction tool. Stroke, 2017, 48(7): 1969-1972.
15.	Walcott BP, Kuklina EV, Nahed BV, et al. Craniectomy for malignant cerebral infarction: prevalence and outcomes in US hospitals. PLoS One, 2011, 6(12): e29193.
16.	Yuan R, Wu S, Cheng Y, et al. Association between preoperative midline shift growing rate and outcomes of decompressive craniectomy in patients with malignant middle cerebral artery infarction. Curr Neurovasc Res, 2020, 17(2): 131-139.
17.	Maramattom BV, Bahn MM, Wijdicks EF. Which patient fares worse after early deterioration due to swelling from hemispheric stroke?. Neurology, 2004, 63(11): 2142-2145.
18.	Malm J, Bergenheim AT, Enblad P, et al. The Swedish Malignant Middle cerebral artery Infarction Study: long-term results from a prospective study of hemicraniectomy combined with standardized neurointensive care. Acta Neurol Scand, 2006, 113(1): 25-30.
19.	Skoglund TS, Eriksson-Ritzén C, S?rbo A, et al. Health status and life satisfaction after decompressive craniectomy for malignant middle cerebral artery infarction. Acta Neurol Scand, 2008, 117(5): 305-310.
20.	Kimberly WT, Bevers MB, von Kummer R, et al. Effect of IV glyburide on adjudicated edema endpoints in the GAMES-RP trial. Neurology, 2018, 91(23): e2163-e2169.
21.	Sheth KN, Kimberly WT, Elm JJ, et al. Exploratory analysis of glyburide as a novel therapy for preventing brain swelling. Neurocrit Care, 2014, 21(1): 43-51.
22.	Bereczki D, Fekete I, Prado GF, et al. Mannitol for acute stroke. Cochrane Database Syst Rev, 2007, 2007(3): CD001153.
23.	Wu S, Yuan R, Xiong Y, et al. Clinical features, management and outcomes of severe ischaemic stroke in tertiary hospitals in China: protocol for a prospective multicentre registry-based observational study. BMJ Open, 2018, 8(10): e024900.
24.	Sandercock PA, Soane T. Corticosteroids for acute ischaemic stroke. Cochrane Database Syst Rev, 2011, 2011(9): CD000064.
25.	中華醫學會神經病學分會神經重癥協作組, 中國醫師協會神經內科醫師分會神經重癥專委會. 大腦半球大面積梗死監護與治療中國專家共識. 中華醫學雜志, 2017, 97(9): 645-652.
26.	Li J, Zhang P, Wu S, et al. Impaired consciousness at stroke onset in large hemisphere infarction: incidence, risk factors and outcome. Sci Rep, 2020, 10(1): 13170.
27.	Li J, Zhang P, Wu S, et al. Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome. Ther Adv Neurol Disord, 2019, 12: 1756286419873264.
28.	Chumbler NR, Williams LS, Wells CK, et al. Derivation and validation of a clinical system for predicting pneumonia in acute stroke. Neuroepidemiology, 2010, 34(4): 193-199.
29.	Masrur S, Smith EE, Saver JL, et al. Dysphagia screening and hospital-acquired pneumonia in patients with acute ischemic stroke: findings from get with the guidelines--stroke. J Stroke Cerebrovasc Dis, 2013, 22(8): e301-e309.
30.	Titsworth WL, Abram J, Fullerton A, et al. Prospective quality initiative to maximize dysphagia screening reduces hospital-acquired pneumonia prevalence in patients with stroke. Stroke, 2013, 44(11): 3154-3160.
31.	張全超, 唐林軍, 陳旭華. 肺部感染合并多器官功能衰竭患者的危險因素分析. 白求恩醫學雜志, 2017, 15(4): 440-441.
32.	Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480?687 adults. Circulation, 2017, 135(8): 759-771.
33.	Wang Y, Li Z, Zhao X, et al. Effect of a multifaceted quality improvement intervention on hospital personnel adherence to performance measures in patients with acute ischemic stroke in China: a randomized clinical trial. JAMA, 2018, 320(3): 245-254.
34.	Chen Y, Wright N, Guo Y, et al. Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0.5 million Chinese adults. Lancet Glob Health, 2020, 8(4): e580-e590.
35.	Cheng Y, Liu J, Zhang S, et al. Prior antithrombotic therapy is associated with cerebral microbleeds in ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease. Front Neurol, 2019, 9: 1184.
36.	國家衛生健康委員會腦卒中防治專家委員會房顫卒中防治專業委員會, 中華醫學會心電生理和起搏分會, 中國醫師協會心律學專業委員會. 中國心源性卒中防治指南(2019). 中華心律失常學雜志, 2019, 23(6): 463-484.
37.	中華醫學會外科學分會血管外科學組. 頸動脈狹窄診治指南. 中國血管外科雜志(電子版), 2017, 9(3): 169-175.
38.	Li J, Zhang P, Tao W, et al. Age-specific clinical characteristics and outcome in patients over 60 years old with large hemispheric infarction. Brain Behav, 2018, 8(12): e01158.
39.	王擁軍. 缺血性卒中的二級預防. 中華神經科雜志, 2021, 54(2): 139-148.
40.	Bai Y, Wang YL, Shantsila A, et al. The global burden of atrial fibrillation and stroke: a systematic review of the clinical epidemiology of atrial fibrillation in Asia. Chest, 2017, 152(4): 810-820.
41.	黃從新, 張澍, 黃德嘉, 等. 心房顫動: 目前的認識和治療建議(2018). 中華心律失常學雜志, 2018, 22(4): 279-346.
42.	符偉國, 王利新, 王玉琦. 顱外段頸動脈狹窄治療指南. 中國實用外科雜志, 2008(11): 913-915.
43.	吳淼, 楊宏, 魯楊, 等. 頸動脈不穩定斑塊轉歸的臨床觀察及隨訪. 中國老年學雜志, 2016, 36(6): 1349-1351.
44.	胡大一. 重視全民高血壓預防. 中華高血壓雜志, 2013(1): 1.

1. Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405.
2. Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
3. Wang Y, Liao X, Zhao X, et al. Using recombinant tissue plasminogen activator to treat acute ischemic stroke in China: analysis of the results from the Chinese National Stroke Registry (CNSR). Stroke, 2011, 42(6): 1658-1664.
4. 王璐, 暢雪麗, 袁若圳, 等. 重癥腦梗死臨床特點及相關影響因素研究. 華西醫學, 2018, 33(6): 665-672.
5. 吳思緲, 吳波, 郭富強, 等. 重癥腦梗死優化診治方案及流程建議草案. 華西醫學, 2019, 34(10): 1096-1108.
6. 吳思緲, 袁若圳, 劉鳴. 應當提倡大面積腦梗死后惡性腦水腫的預防理念及其研究. 中華神經科雜志, 2020, 53(4): 244-249.
7. 郭睿, 于志淵, 吳思緲, 等. 大面積腦梗死惡性腦水腫外科減壓術規范化循證治療建議草案. 中國循證醫學雜志, 2021, 21(5): 503-513.
8. Wu S, Yuan R, Wang Y, et al. Early prediction of malignant brain edema after ischemic stroke. Stroke, 2018, 49(12): 2918-2927.
9. Volny O, Cimflova P, Lee TY, et al. Permeability surface area product analysis in malignant brain edema prediction - a pilot study. J Neurol Sci, 2017, 376: 206-210.
10. Wang L, Guo W, Wang C, et al. Dynamic change of neutrophil to lymphocyte ratios and infection in patients with acute ischemic stroke. Curr Neurovasc Res, 2020, 17(3): 294-303.
11. 李昱曉, 周紅青, 劉鳴. 大面積腦梗死發生和預后相關因素研究. 華西醫學, 2018, 33(6): 684-690.
12. Bai X, Wang C, Wang L, et al. Association between neutrophil to lymphocyte ratio and malignant brain edema in patients with large hemispheric infarction. Curr Neurovasc Res, 2020, 17(4): 429-436.
13. Cheng Y, Wu S, Wang Y, et al. External validation and modification of the EDEMA score for predicting malignant brain edema after acute ischemic stroke. Neurocrit Care, 2020, 32(1): 104-112.
14. Ong CJ, Gluckstein J, Laurido-Soto O, et al. Enhanced detection of Edema in Malignant Anterior Circulation Stroke (EDEMA) score: a risk prediction tool. Stroke, 2017, 48(7): 1969-1972.
15. Walcott BP, Kuklina EV, Nahed BV, et al. Craniectomy for malignant cerebral infarction: prevalence and outcomes in US hospitals. PLoS One, 2011, 6(12): e29193.
16. Yuan R, Wu S, Cheng Y, et al. Association between preoperative midline shift growing rate and outcomes of decompressive craniectomy in patients with malignant middle cerebral artery infarction. Curr Neurovasc Res, 2020, 17(2): 131-139.
17. Maramattom BV, Bahn MM, Wijdicks EF. Which patient fares worse after early deterioration due to swelling from hemispheric stroke?. Neurology, 2004, 63(11): 2142-2145.
18. Malm J, Bergenheim AT, Enblad P, et al. The Swedish Malignant Middle cerebral artery Infarction Study: long-term results from a prospective study of hemicraniectomy combined with standardized neurointensive care. Acta Neurol Scand, 2006, 113(1): 25-30.
19. Skoglund TS, Eriksson-Ritzén C, S?rbo A, et al. Health status and life satisfaction after decompressive craniectomy for malignant middle cerebral artery infarction. Acta Neurol Scand, 2008, 117(5): 305-310.
20. Kimberly WT, Bevers MB, von Kummer R, et al. Effect of IV glyburide on adjudicated edema endpoints in the GAMES-RP trial. Neurology, 2018, 91(23): e2163-e2169.
21. Sheth KN, Kimberly WT, Elm JJ, et al. Exploratory analysis of glyburide as a novel therapy for preventing brain swelling. Neurocrit Care, 2014, 21(1): 43-51.
22. Bereczki D, Fekete I, Prado GF, et al. Mannitol for acute stroke. Cochrane Database Syst Rev, 2007, 2007(3): CD001153.
23. Wu S, Yuan R, Xiong Y, et al. Clinical features, management and outcomes of severe ischaemic stroke in tertiary hospitals in China: protocol for a prospective multicentre registry-based observational study. BMJ Open, 2018, 8(10): e024900.
24. Sandercock PA, Soane T. Corticosteroids for acute ischaemic stroke. Cochrane Database Syst Rev, 2011, 2011(9): CD000064.
25. 中華醫學會神經病學分會神經重癥協作組, 中國醫師協會神經內科醫師分會神經重癥專委會. 大腦半球大面積梗死監護與治療中國專家共識. 中華醫學雜志, 2017, 97(9): 645-652.
26. Li J, Zhang P, Wu S, et al. Impaired consciousness at stroke onset in large hemisphere infarction: incidence, risk factors and outcome. Sci Rep, 2020, 10(1): 13170.
27. Li J, Zhang P, Wu S, et al. Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome. Ther Adv Neurol Disord, 2019, 12: 1756286419873264.
28. Chumbler NR, Williams LS, Wells CK, et al. Derivation and validation of a clinical system for predicting pneumonia in acute stroke. Neuroepidemiology, 2010, 34(4): 193-199.
29. Masrur S, Smith EE, Saver JL, et al. Dysphagia screening and hospital-acquired pneumonia in patients with acute ischemic stroke: findings from get with the guidelines--stroke. J Stroke Cerebrovasc Dis, 2013, 22(8): e301-e309.
30. Titsworth WL, Abram J, Fullerton A, et al. Prospective quality initiative to maximize dysphagia screening reduces hospital-acquired pneumonia prevalence in patients with stroke. Stroke, 2013, 44(11): 3154-3160.
31. 張全超, 唐林軍, 陳旭華. 肺部感染合并多器官功能衰竭患者的危險因素分析. 白求恩醫學雜志, 2017, 15(4): 440-441.
32. Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480?687 adults. Circulation, 2017, 135(8): 759-771.
33. Wang Y, Li Z, Zhao X, et al. Effect of a multifaceted quality improvement intervention on hospital personnel adherence to performance measures in patients with acute ischemic stroke in China: a randomized clinical trial. JAMA, 2018, 320(3): 245-254.
34. Chen Y, Wright N, Guo Y, et al. Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0.5 million Chinese adults. Lancet Glob Health, 2020, 8(4): e580-e590.
35. Cheng Y, Liu J, Zhang S, et al. Prior antithrombotic therapy is associated with cerebral microbleeds in ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease. Front Neurol, 2019, 9: 1184.
36. 國家衛生健康委員會腦卒中防治專家委員會房顫卒中防治專業委員會, 中華醫學會心電生理和起搏分會, 中國醫師協會心律學專業委員會. 中國心源性卒中防治指南(2019). 中華心律失常學雜志, 2019, 23(6): 463-484.
37. 中華醫學會外科學分會血管外科學組. 頸動脈狹窄診治指南. 中國血管外科雜志(電子版), 2017, 9(3): 169-175.
38. Li J, Zhang P, Tao W, et al. Age-specific clinical characteristics and outcome in patients over 60 years old with large hemispheric infarction. Brain Behav, 2018, 8(12): e01158.
39. 王擁軍. 缺血性卒中的二級預防. 中華神經科雜志, 2021, 54(2): 139-148.
40. Bai Y, Wang YL, Shantsila A, et al. The global burden of atrial fibrillation and stroke: a systematic review of the clinical epidemiology of atrial fibrillation in Asia. Chest, 2017, 152(4): 810-820.
41. 黃從新, 張澍, 黃德嘉, 等. 心房顫動: 目前的認識和治療建議(2018). 中華心律失常學雜志, 2018, 22(4): 279-346.
42. 符偉國, 王利新, 王玉琦. 顱外段頸動脈狹窄治療指南. 中國實用外科雜志, 2008(11): 913-915.
43. 吳淼, 楊宏, 魯楊, 等. 頸動脈不穩定斑塊轉歸的臨床觀察及隨訪. 中國老年學雜志, 2016, 36(6): 1349-1351.
44. 胡大一. 重視全民高血壓預防. 中華高血壓雜志, 2013(1): 1.

Next Article
High-resolution magnetic resonance imaging in intracranial atherosclerotic disease

West China Medical Journal

Reinforce the awareness of prevention of critical cerebral infarction by categories and phases

Abstract Full text Figures/Tables Video References Cited by

Next Article

Format

Content