{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:43:17Z","timestamp":1778805797311,"version":"3.51.4"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Malignant cerebellar edema (MCE) is a life-threatening complication of acute ischemic stroke that requires timely diagnosis and management. Aim of this study was to identify imaging predictors in initial multiparametric computed tomography (CT), including whole-brain CT perfusion (WB-CTP).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We consecutively selected all subjects with cerebellar ischemic WB-CTP deficits and follow-up\u2013confirmed cerebellar infarction from an initial cohort of 2635 patients who had undergone multiparametric CT because of suspected stroke. Follow-up imaging was assessed for the presence of MCE, measured using an established 10-point scale, of which scores \u22654 are considered malignant. Posterior circulation\u2013Acute Stroke Prognosis Early CT Score (pc-ASPECTS) was determined to assess ischemic changes on noncontrast CT, CT angiography (CTA), and parametric WB-CTP maps (cerebellar blood flow [CBF]; cerebellar blood volume; mean transit time; time to drain). Fisher\u2019s exact tests, Mann\u2013Whitney U tests, and receiver operating characteristics analyses were performed for statistical analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Out of a total of 51 patients who matched the inclusion criteria, 42 patients (82.4%) were categorized as MCE\u2212 and 9 (17.6%) as MCE+. MCE+ patients had larger CBF, cerebellar blood volume, mean transit time, and time to drain deficit volumes (all with\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and showed significantly lower median pc-ASPECTS assessed using WB-CTP (CBF, cerebellar blood volume, mean transit time, time to drain; all with\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) compared with MCE\u2212 patients, while median pc-ASPECTS on noncontrast CT and CTA was not significantly different (both\n              <jats:italic>P<\/jats:italic>\n              &gt;0.05). Receiver operating characteristics analyses yielded the largest area under the curve values for the prediction of MCE development for CBF (0.979) and cerebellar blood volume deficit volumes (0.956) and pc-ASPECTS on CBF (0.935), whereas pc-ASPECTS on noncontrast CT (0.648) and CTA (0.684) had less diagnostic value. The optimal cutoff value for CBF deficit volume was 22 mL, yielding 100% sensitivity and 90% specificity for MCE classification.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>WB-CTP provides added diagnostic value for the early identification of patients at risk for MCE development in acute cerebellar stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.117.018237","type":"journal-article","created":{"date-parts":[[2017,7,8]],"date-time":"2017-07-08T01:10:41Z","timestamp":1499476241000},"page":"2597-2600","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Early Imaging Prediction of Malignant Cerebellar Edema Development in Acute Ischemic Stroke"],"prefix":"10.1161","volume":"48","author":[{"given":"Matthias P.","family":"Fabritius","sequence":"first","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kolja M.","family":"Thierfelder","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix G.","family":"Meinel","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed E.","family":"Othman","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Dorn","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian O.","family":"Sabel","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Scheffler","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit","family":"Ertl-Wagner","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wieland H.","family":"Sommer","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang G.","family":"Kunz","sequence":"additional","affiliation":[{"name":"From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70216-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.550913"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000441965.15164.d6"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.008718"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2001.tb00045.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.9.2062"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.2.287"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.619734"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4637"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.117.018237","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:52:49Z","timestamp":1715611969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.117.018237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9]]},"references-count":9,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1161\/STROKEAHA.117.018237"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.117.018237","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9]]},"assertion":[{"value":"2017-05-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}