Antihyperthermic Treatment in the Management of Malignant Infarction of the Middle Cerebral Artery

Maria Luz Alonso-Alonso, Ana Sampedro-Viana, Manuel Rodríguez-Yáñez, Iria López-Dequidt, José M. Pumar, Antonio J. Mosqueira, Alberto Ouro, Paulo Ávila-Gómez, Tomás Sobrino, Francisco Campos, José Castillo, Pablo Hervella, Ramón Iglesias-Rey

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Malignant infarction of the middle cerebral artery (m-MCA) is a complication of ischemic stroke. Since hyperthermia is a predictor of poor outcome, and antihyperthermic treatment is well tolerated, our main aim was to analyze whether the systemic temperature decrease within the first 24 h was associated with a better outcome. Furthermore, we studied potential biochemical and neuroimaging biomarkers. This is a retrospective observational analysis that included 119 patients. The temperature variations within the first 24 h were recorded. Biochemical laboratory parameters and neuroimaging variables were also analyzed. The temperature increase at the first 24 h (OR: 158.97; CI 95%: 7.29–3465.61; p < 0.001) was independently associated with a higher mortality. Moreover, antihyperthermic treatment (OR: 0.08; CI 95%: 0.02–0.38; p = 0.002) was significantly associated with a good outcome at 3 months. Importantly, antihyperthermic treatment was associated with higher survival at 3 months (78% vs. 50%, p = 0.003). Significant independently associations between the development of m-MCA and both microalbuminuria (OR: 1.01; CI 95%: 1.00–1.02; p = 0.005) and leukoaraiosis (OR: 3.07; CI 1.84–5.13–1.02; p < 0.0001) were observed. Thus, antihyperthermic treatment within the first 24 h was associated with both a better outcome and higher survival. An increased risk of developing m-MCA was associated with leukoaraiosis and an elevated level of microalbuminuria.

Original languageEnglish
Article number2874
JournalJournal of Clinical Medicine
Volume11
Issue number10
DOIs
StatePublished - 1 May 2022
Externally publishedYes

Keywords

  • antihyperthermic treatment
  • ischemic stroke
  • leukoaraiosis
  • malignant infarction of the middle cerebral artery
  • microalbuminuria

ASJC Scopus subject areas

  • General Medicine

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