Abstract
AimsTo investigate the relationship between peripheral leukocyte dynamics and the outcome of large hemispheric infarction (LHI) patients.MethodsPatients with acute LHI admitted to the neuro‐intensive care unit of Xuanwu Hospital from 2013 to 2017 were prospectively enrolled and followed up for 6 months after LHI.ResultsA total of 84 LHI patients were included, 38 patients suffered brain herniation and 20 patients died from stroke. Compared to patients with benign course, LHI patients with fatal outcome showed larger infarcts and more severe brain edema (P < .01), as well as increased WBC and neutrophil counts throughout the first week after stroke (P < .05). Correlation analysis revealed that neutrophil counts on D2 after LHI positively correlated with infarct and edema volumes measured from CT/MRI (R2 = 0.22 and R 2 = 0.15, P < .01) and negatively correlated with Glasgow Coma Scale (ρ = −0.234, P < .05). Patients with D2 neutrophils > 7.14 × 109/L had higher risk of brain herniation [odds ratio (OR) = 7.5, 95% CI: 2.0‐28.1, P = .001], and patients with D2 neutrophils > 7.79 × 109/L had a higher risk of death (OR = 5.8, 95% CI: 1.2‐27.0, P = .015).ConclusionEarly peripheral neutrophil count after stroke relates to infarct size and the fatal outcome of LHI patients, which might help guiding acute LHI management such as reduction of intracranial pressure and potential antiinflammatory therapy in the future.
Highlights
Large hemispheric infarction (LHI) accounts for approximately 10% to 15% of ischemic stroke events and is associated with high mortality and poor outcome.[1]
Univariate logistic regression revealed that both white blood cell (WBC) and neutrophil counts on D2 were significantly related to brain herniation [odds ratio (OR) = 1.166, 95% CI: 1.019-1.334, P = .025; OR = 1.201, 95% CI: 1.041-1.386, P = .012, respectively], and D2 neutrophil count significantly related to death (OR = 1.233, 95% CI: 1.053-1.444, P = .009)
Our study found that LHI patients developing brain herniation or succumbing to stroke showed higher WBC and neutrophils counts within the first week after stroke
Summary
Large hemispheric infarction (LHI) accounts for approximately 10% to 15% of ischemic stroke events and is associated with high mortality and poor outcome.[1]. Leukocytes, neutrophils, have been reported to play an important role in experimental stroke.[5,6,7] the evidence in stroke patients is still limited.[8] few studies have. | 830 investigated the dynamics of leukocyte after LHI and its relationship with infarct and edema volumes, or fatal outcomes including brain herniation and death. We aimed to investigate the potential relationship between leukocyte changes of LHI patient within one week after symptom onset and the outcome including brain herniation and death
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