{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:07:32Z","timestamp":1789463252199,"version":"build-2803163510"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Scientific Foundation of China","award":["82271983"],"award-info":[{"award-number":["82271983"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    Malignant cerebral edema (MCE) is a life-threatening complication after endovascular therapy (EVT) for acute ischemic stroke (AIS). In this multicenter study, we observed a specific gyral hyperdensity sign (GHS) and sought to investigate its association with MCE, analyzing the underlying factors correlated with GHS. Consecutive anterior circulation AIS patients exhibiting post-EVT hyperdensities on 24-h follow-up computed tomography were included. GHS was defined as curvilinear hyperdensities distributed along \u2a7e2 adjacent cerebral gyri. A total of 542 patients were enrolled. GHS was identified in 142 patients with excellent interobserver agreement (\u03ba\u2009=\u20090.804). We found that GHS (OR\u2009=\u20091.83, 95% CI\u2009=\u20091.13\u20132.95,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.014) was independently associated with MCE. Furthermore, baseline NIHSS score (OR\u2009=\u20091.05, 95% CI\u2009=\u20091.02\u20131.09,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.003), blood glucose (OR\u2009=\u20091.15, 95% CI\u2009=\u20091.05\u20131.25,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.002), infarct ASPECTS (OR\u2009=\u20090.91, 95% CI\u2009=\u20090.83\u20130.99,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.024), creatinine level (OR\u2009=\u20093.47, 95% CI\u2009=\u20091.71\u20137.02,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001), and intracranial internal carotid artery occlusion (OR\u2009=\u20091.66, 95% CI\u2009=\u20091.09\u20132.55,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.020) were independently correlated with GHS. These results revealed that GHS can be reliably identified and can serve as an early warning indicator for MCE.\n                  <\/jats:p>","DOI":"10.1177\/0271678x261417192","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:41:26Z","timestamp":1770291686000},"page":"1708-1716","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Post-endovascular treatment gyral hyperdensity sign: A warning sign preceding malignant cerebral edema in ischemic stroke"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3683-7163","authenticated-orcid":false,"given":"Xi","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sishan","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Nanjing Jinling Hospital, the First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiji","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ChangSheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AnYu","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Chen","sequence":"additional","affiliation":[{"name":"Departments of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6664-7224","authenticated-orcid":false,"given":"Longjiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XinDao","family":"Yin","sequence":"additional","affiliation":[{"name":"Departments of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 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