Anterior Temporal Artery Sign in CT Angiography Predicts
Reduced Fatal Brain Edema and Mortality in Acute M1
Middle Cerebral Artery Occlusions
- Author(s)
- Bijoy K. Menon; Simerpreet Bal; Jayesh Modi; Sung Il Sohn; Timothy W.J. Watson; Michael D. Hill; Andrew M. Demchuk; Mayank Goyal
- Keimyung Author(s)
- Sohn, Sung Il
- Department
- Dept. of Neurology (신경과학)
- Journal Title
- Journal of Neuroimaging
- Issued Date
- 2012
- Volume
- 22
- Issue
- 2
- Keyword
- Anterior temporal artery; malignant MCA infarction; mortality
- Abstract
- BACKGROUND:
Mortality in acute ischemic middle cerebral artery (MCA) stroke ranges from 5% to 45%.
We identify a vascular imaging sign, presence of “prominent anterior temporal artery”
on computed tomography (CT) angiography (CTA) and investigate whether it predicts
mortality in acute M1-MCA occlusions.
METHODS:
One hundred and two patients with acute M1-MCA occlusions from 2003–to 2007 were
included in the study. A prominent anterior temporal artery arising from proximal M1 MCA
was identified by two readers blinded to clinical outcome. Primary clinical outcome was
survival (modified Rankin Scale [mRS] 0-5) at 3 months.
RESULTS:
An anterior temporal artery arising from M1 MCA was present in 20/102 (20%). Eighteen
of 20 (90%) patients with this sign survived at 3 months (mRS 0-5) when compared
to 66/82 (80.4%) patients without the sign (odds ratio 2.2 CI95 .5-10.4). The sign has
a sensitivity of 21% (CI95 .13-.25) but specificity of 89% (CI95 .64-.98) in predicting
survival at 3 months. Positive predictive value was 90% with likelihood ratio of 1.9
(CI95 .9-7.6).
CONCLUSION:
Presence of prominent anterior temporal artery in M1-MCA occlusions on CTA identifies a
group of patients with reduced case fatality. The mechanism is likely related to a reduced
chance of malignant cerebral edema.
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