{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:37:37Z","timestamp":1792139857416,"version":"4.4.0"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nTherapeutic reperfusion with endovascular treatment (EVT) for acute ischemic stroke is typically associated with better long-term functional outcome compared to standard medical care. However, post-procedural brain edema remained present in around half of EVT patients. Malignant brain edema (MBE) is a serious condition that can lead to increased intracranial pressure, rapid neurologic deterioration, and cerebral herniation, neutralizing the favorable efficacy of EVT on functional outcomes.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 51-year-old man with a history of atrial fibrillation presented with acute onset of hemiplegia and severe bradyarrhythmia. A head computed tomography-scan demonstrated hyperdense middle cerebral artery (MCA) sign. Intravenous thrombolysis was administered before temporary pacemaker insertion. The digital subtraction angiography confirmed occlusion of the M1 branch of the right MCA with no collaterals in the territory of the occluded vessel. Mechanical thrombectomy (MT) was performed 6 h after onset and successfully achieved modified thrombolysis in cerebral infarction 3 revascularization in 6 h 20 min. The patient later experienced massive brain edema that required emergent decompressive craniectomy. The modified Rankin scale score was 4 in 1- and 3-month\u2019s follow-up.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nMBE after MT results in unsatisfactory functional outcomes, even if it has successful revascularization. No collateral in the territory of the occluded vessel in the initial angiogram is one of the predictors of MBE after MT.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_28_2023","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T06:28:12Z","timestamp":1680244092000},"page":"111","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Case of malignant brain edema despite successful recanalization after mechanical thrombectomy for anterior circulation stroke"],"prefix":"10.25259","volume":"14","author":[{"given":"Nur Setiawan","family":"Suroto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asra Al","family":"Fauzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayu Yoniko","family":"Christi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Ariel Tiopan","family":"Simanjuntak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perthdyatama Syifaq","family":"Budiono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"10.25259\/SNI_28_2023\/ref-1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.3171\/jns.1985.62.1.0031","article-title":"CBF and time thresholds for the formation of ischemic cerebral edema, and effect of reperfusion in baboons","volume":"62","author":"Bell","year":"1985","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_28_2023\/ref-2","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/S1474-4422(16)30177-6","article-title":"Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): A randomised controlled trial","volume":"15","author":"Bracard","year":"2016","journal-title":"Lancet Neurol"},{"key":"10.25259\/SNI_28_2023\/ref-3","doi-asserted-by":"crossref","first-page":"116507","DOI":"10.1016\/j.jns.2019.116507","article-title":"A prediction model of brain edema after endovascular treatment in patients with acute ischemic stroke","volume":"407","author":"Chen","year":"2019","journal-title":"J Neurol Sci"},{"key":"10.25259\/SNI_28_2023\/ref-4","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.2147\/NDT.S279303","article-title":"A nomogram model to predict malignant cerebral edema in ischemic stroke patients treated with endovascular thrombectomy: An observational study","volume":"16","author":"Du","year":"2020","journal-title":"Neuropsychiatr Dis Treat"},{"key":"10.25259\/SNI_28_2023\/ref-5","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1136\/neurintsurg-2015-011731","article-title":"CTA collateral score predicts infarct volume and clinical outcome after endovascular therapy for acute ischemic stroke: A retrospective chart review","volume":"8","author":"Elijovich","year":"2016","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_28_2023\/ref-6","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1006\/exnr.1997.6635","article-title":"Influence of ischemia and reperfusion on the course of brain tissue swelling and blood-brain barrier permeability in a rodent model of transient focal cerebral ischemia","volume":"147","author":"Gartshore","year":"1997","journal-title":"Exp Neurol"},{"key":"10.25259\/SNI_28_2023\/ref-7","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials","volume":"387","author":"Goyal","year":"2016","journal-title":"Lancet"},{"key":"10.25259\/SNI_28_2023\/ref-8","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1136\/neurintsurg-2018-014650","article-title":"Predictors of malignant brain edema after mechanical thrombectomy for acute ischemic stroke","volume":"11","author":"Huang","year":"2019","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_28_2023\/ref-9","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1177\/0271678X17720559","article-title":"Reperfusion after ischemic stroke is associated with reduced brain edema","volume":"38","author":"Irvine","year":"2018","journal-title":"J Cerebral Blood Flow Metab"},{"key":"10.25259\/SNI_28_2023\/ref-10","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00415-018-09173-0","article-title":"Incidence and mechanism of early neurological deterioration after endovascular thrombectomy","volume":"266","author":"Kim","year":"2019","journal-title":"J Neurol"},{"key":"10.25259\/SNI_28_2023\/ref-11","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1001\/jamaneurol.2017.5162","article-title":"Association of reperfusion with brain edema in patients with acute ischemic stroke: A secondary analysis of the MR CLEAN Trial","volume":"75","author":"Kimberly","year":"2018","journal-title":"JAMA Neurol"},{"key":"10.25259\/SNI_28_2023\/ref-12","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1161\/01.STR.0000086465.41263.06","article-title":"Collateral circulation","volume":"34","author":"Liebeskind","year":"2003","journal-title":"Stroke"},{"key":"10.25259\/SNI_28_2023\/ref-13","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1136\/neurintsurg-2014-011602","article-title":"Clinical diffusion mismatch better discriminates infarct growth than mean transit time-diffusion weighted imaging mismatch in patients with middle cerebral artery-M1 occlusion and limited infarct core","volume":"9","author":"Nogueira","year":"2017","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_28_2023\/ref-14","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1038\/jcbfm.2009.106","article-title":"Cerebral ischemia-reperfusion injury in rats-A 3 T MRI study on biphasic blood-brain barrier opening and the dynamics of edema formation","volume":"29","author":"Pillai","year":"2009","journal-title":"J Cereb Blood Flow Metab"},{"key":"10.25259\/SNI_28_2023\/ref-15","doi-asserted-by":"crossref","first-page":"3020","DOI":"10.1161\/STR.0000000000000074","article-title":"2015 American Heart Association\/American stroke association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: A guideline for healthcare professionals from the American","volume":"46","author":"Powers","year":"2015","journal-title":"Stroke"},{"key":"10.25259\/SNI_28_2023\/ref-16","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/1747493018799979","article-title":"Factors that may contribute to poor outcome despite good reperfusion after acute endovascular stroke therapy","volume":"14","author":"Rabinstein","year":"2019","journal-title":"Int J Stroke"},{"key":"10.25259\/SNI_28_2023\/ref-17","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1001\/jama.2016.13647","article-title":"Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: A meta-analysis","volume":"316","author":"Saver","year":"2016","journal-title":"JAMA"},{"key":"10.25259\/SNI_28_2023\/ref-18","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3340\/jkns.2015.58.4.321","article-title":"Extent of contrast enhancement on non-enhanced computed tomography after intra-arterial thrombectomy for acute infarction on anterior circulation : As a predictive value for malignant brain edema","volume":"58","author":"Song","year":"2015","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI_28_2023\/ref-19","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1161\/STROKEAHA.120.029593","article-title":"Early NT-ProBNP (N-terminal probrain natriuretic peptide) elevation predicts malignant edema and death after reperfusion therapy in acute ischemic stroke patients","volume":"52","author":"Zhang","year":"2021","journal-title":"Stroke"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/case-of-malignant-brain-edema-despite-successful-recanalization-after-mechanical-thrombectomy-for-anterior-circulation-stroke\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/case-of-malignant-brain-edema-despite-successful-recanalization-after-mechanical-thrombectomy-for-anterior-circulation-stroke\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T06:28:20Z","timestamp":1680244100000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/case-of-malignant-brain-edema-despite-successful-recanalization-after-mechanical-thrombectomy-for-anterior-circulation-stroke\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,31]]},"references-count":19,"alternative-id":["10.25259\/SNI_28_2023"],"URL":"https:\/\/doi.org\/10.25259\/sni_28_2023","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2023,3,31]]},"article-number":"111"}}