Prediction of malignant middle cerebral artery infarction by a rater independent model based on normalized stroke volume and subarachnoid space volume

Introduction: Surgical decompression improves outcome in patients with malignant middle cerebral artery (MCA) infarction when performed early. However, objective parameters that reliably predict a malignant course of MCA infarction have not been determined so far. We hypothesized that stroke volume and pre-stroke subarachnoid space (CSF), which indicates the intracranial volume reserve, are major determinants to develop a malignant MCA infarction. We here present a method which allows prediction of the course of large MCA infarction based on CT imaging at admission including perfusion CT. Methods: Patients with…