Friday, January 5, 2018

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.


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.

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