TITLE:
Malignant Sylvian Infarction: Epidemiological, Clinical and Prognostic Aspects at the Institute of Neurology of Simbaya, Conakry
AUTHORS:
Namory Camara, Mohamed Tafsir Diallo, Malé Doré, Mohamed Lamine Condé, Karimka Diawara, Djènè Keita, Fodé Abass Cissé
KEYWORDS:
Malignant Sylvian Infarction, Respiratory Distress, Aspiration Pneumonia, Cerebral Herniation, INS
JOURNAL NAME:
World Journal of Neuroscience,
Vol.15 No.1,
February
28,
2025
ABSTRACT: Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It represents about 10% of all AICs, with a mortality of up to 80%. The objectives of our study were to describe the sociodemographic profile and the main clinical manifestations and identify the prognostic factors of ISM. Material and Methods: We conducted a retrospective descriptive study over a 2-year period. It included patients hospitalized for cerebral infarction involving 2/3 of the ACM territory with a NIHSS score ≥ 17 and/or a Glasgow score Results: We collected 223 patients hospitalized for ischemic stroke, of whom 21 patients (9.4%) presented with ISM. The mean age was 57.43 ± 24.24 years with a male predominance (52.4%). The mean admission time was 47 ± 0.87 hours, and hemiplegia was the frequent neurological sign (85.7%). HBP was the common cardiovascular risk factor (76.2%). The mean NIHSS at admission was 18.38 ± 12.29. Respiratory distress (p-value = 0.00015), aspiration pneumonia (p-value = 0.015) and brain herniation (p-value = 0.014) were the main complications associated with mortality. Conclusion: ISM is associated with poor prognosis in the absence of surgical treatment. Respiratory distress, aspiration pneumonia and brain herniation are associated with high mortality.