Young age and CVA

Q: Young age is an independent risk factor for malignant middle cerebral artery (MCA) territory infarction (select one)

A) True
B) False 



Answer: True

After ischemic infarct, the development of space-occupying cerebral edema which is severe enough to cause elevated intracranial pressure (ICP) and brain herniation is regarded as malignant infarction. It may sound surprising but old age provides a protective effect due to cerebral atrophy. It is more  accommodative of cerebral edema after infarct! 

It carries extremely high mortality.



References:

1. Krieger DW, Demchuk AM, Kasner SE, et al. Early clinical and radiological predictors of fatal brain swelling in ischemic stroke. Stroke 1999; 30:287. 

2. Hacke W, Schwab S, Horn M, et al. 'Malignant' middle cerebral artery territory infarction: clinical course and prognostic signs. Arch Neurol 1996; 53:309.