{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:04:35Z","timestamp":1789146275448,"version":"build-2803163510"},"reference-count":18,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2024,7,16]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Malignant swelling is a fatal complication that can occur abruptly in space-occupying cerebellar infarction. We aimed to establish markers that predict malignant swelling in cerebellar infarction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively analysed data of stroke patients who were treated in our hospital between 2014 and 2020. Malignant swelling was defined as a mass effect in the posterior cranial fossa, accompanied by a decrease in consciousness due to compression of the brainstem and\/or the development of obstructive hydrocephalus. Statistical analyses were performed on multiple variables to identify predictors of malignant swelling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 7284 stroke patients, we identified 487 patients with an infarct in the cerebellum. 93 patients were suitable for analysis having space-occupying cerebellar infarction. 33 of 93 (35.5%) patients developed malignant swelling. Multivariable analysis revealed infarct volume as the main predictor being independently associated with the development of malignant swelling with a cut-off infarct volume of 38 cm<jats:sup>3<\/jats:sup> being associated with a swelling rate of &gt;50% (OR 32.0, p&lt;0.001). Higher NIHSS (National Institutes of Health Stroke Scale) score on admission (median NIHSS 12 vs 4, OR 1.078; p=0.008) and the presence of additional brainstem infarction (51.5% vs 16.7%, OR 5.312; p=0.013) were associated with the development of malignant swelling in univariate analyses. 13 of 33 (39.4%) cases of malignant swellings occurred after more than 3\u2009days.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Infarct volume was the key significant predictor of malignant swelling in space-occupying cerebellar infarction. With many cases of malignant swelling occurring after more than 72 hours, we advocate prolonged neurological monitoring.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/svn-2024-003360","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T22:25:14Z","timestamp":1724970314000},"page":"323-329","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of malignant swelling in space-occupying cerebellar infarction"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4766-2781","authenticated-orcid":false,"given":"Enayatullah","family":"Baki","sequence":"first","affiliation":[{"name":"Department of Neurology, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Baumgart","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Kehl","sequence":"additional","affiliation":[{"name":"Institute of AI and Informatics in Medicine, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Hess","sequence":"additional","affiliation":[{"name":"Department of Neurology, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Wolfgang","family":"Wolff","sequence":"additional","affiliation":[{"name":"Department of Neurology, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz Roman","family":"Hernandez Petzsche","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Boeckh-Behrens","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Hemmer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"},{"name":"Munich Cluster for Systems Neurology, (SyNergy), Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Gempt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Wunderlich","sequence":"additional","affiliation":[{"name":"Department of Neurology, Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"2025082410431822000_10.3.323.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70216-3"},{"key":"2025082410431822000_10.3.323.2","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1212\/WNL.0b013e3181aa5329","article-title":"ABC\/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes","volume":"72","author":"Sims","year":"2009","journal-title":"Neurology 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Surgically Treated Cerebellar Infarcts","volume":"81","author":"Won","year":"2024","journal-title":"JAMA Neurol"},{"key":"2025082410431822000_10.3.323.7","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.clineuro.2018.11.023","article-title":"Long-term functional outcome after decompressive suboccipital craniectomy for space-occupying cerebellar infarction","volume":"176","author":"Lindeskog","year":"2019","journal-title":"Clin Neurol Neurosurg"},{"key":"2025082410431822000_10.3.323.8","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.550871"},{"key":"2025082410431822000_10.3.323.9","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.550913"},{"key":"2025082410431822000_10.3.323.10","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00330-022-09013-w","article-title":"Predictors of malignant middle cerebral artery infarction after endovascular thrombectomy: results of DIRECT-MT 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Anatomy, head and neck: basilar artery. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2024. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459137\/"},{"key":"2025082410431822000_10.3.323.16","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.014727"},{"key":"2025082410431822000_10.3.323.17","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200301000-00043"},{"key":"2025082410431822000_10.3.323.18","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.670430"}],"container-title":["Stroke and Vascular Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/svn-2024-003360","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T17:43:29Z","timestamp":1756057409000},"score":1,"resource":{"primary":{"URL":"https:\/\/svn.bmj.com\/lookup\/doi\/10.1136\/svn-2024-003360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,6,30]]},"published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1136\/svn-2024-003360"],"URL":"https:\/\/doi.org\/10.1136\/svn-2024-003360","relation":{},"ISSN":["2059-8688","2059-8696"],"issn-type":[{"value":"2059-8688","type":"print"},{"value":"2059-8696","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]}}}