{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T07:33:49Z","timestamp":1793432029310,"version":"4.5.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Brain edema is the leading cause of death in patients with malignant middle cerebral artery (MCA) infarction. Midline shift (MLS) has been used as a monohemispheric brain edema marker in several studies; however, it does not precisely measure brain edema. It is now possible to directly measure hemisphere brain volume. Knowledge about the time course of brain edema after malignant middle cerebral artery infarction may contribute to the condition's management.<\/jats:p><jats:p>\n          Objective\u2003Therefore, our goal was to evaluate the course of brain edema in patients with malignant MCA infarction treated with decompressive craniectomy (DC) using hemispheric volumetric measurements.<\/jats:p><jats:p>\n          Methods\u2003Patients were selected consecutively from a single tertiary hospital between 2013 and 2019. All patients were diagnosed with malignant middle cerebral artery infarction and underwent a decompressive craniectomy (DC) to treat the ischemic event. All computed tomography (CT) exams performed during the clinical care of these patients were analyzed, and the whole ischemic hemisphere volume was calculated for each CT scan.<\/jats:p><jats:p>\n          Results\u2003We analyzed 43 patients (197 CT exams). Patients' mean age at DC was 51.72 [range: 42\u201368] years. The mean time between the ischemic ictus and DC was 41.88 (range: 6\u201377) hours. The mean time between the ischemic event and the peak of hemisphere volume was 168.84 (95% confidence interval [142.08, 195.59]) hours.<\/jats:p><jats:p>\n          Conclusion\u2003In conclusion, the peak of cerebral edema in malignant MCA infarction after DC occurred on the 7th day (168.84\u2009h) after stroke symptoms onset. Further studies evaluating therapies for brain edema even after DC should be investigated.<\/jats:p>","DOI":"10.1055\/s-0043-1764415","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T07:07:49Z","timestamp":1683702469000},"page":"345-349","source":"Crossref","is-referenced-by-count":5,"title":["Time course of hemispheric cerebral volume after decompressive craniectomy in malignant middle cerebral artery stroke"],"prefix":"10.1055","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4643-5339","authenticated-orcid":false,"given":"Thiago Pereira","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7566-3632","authenticated-orcid":false,"given":"Mariana Athaniel Silva","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Departamento de Radiologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4809-0159","authenticated-orcid":false,"given":"Leonardo Favi","family":"Bocca","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7874-7452","authenticated-orcid":false,"given":"Feres Eduardo Chaddad","family":"Neto","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9750-0508","authenticated-orcid":false,"given":"Sergio","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5889-1382","authenticated-orcid":false,"given":"Edson Amaro","family":"J\u00fanior","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Departamento de Radiologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5692-8671","authenticated-orcid":false,"given":"Gisele Sampaio","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."},{"name":"Hospital Israelita Albert Einstein, Organiza\u00e7\u00e3o de Pesquisa Acad\u00eamica, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9734-7339","authenticated-orcid":false,"given":"Italo Capraro","family":"Suriano","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-8451","authenticated-orcid":false,"given":"Ricardo Silva","family":"Centeno","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, 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