Stroke, Vol 17, 865-871, Copyright © 1986 by American Heart Association
L Berger and AM Hakim
A retrospective review of stroke patients admitted to our hospital revealed
39 patients diagnosed as suffering an acute completed ischemic stroke who
also had had fasting (AC) serum glucose determinations and sequential
computer tomography (CT) studies. The patients were divided into three
groups on the basis of mean AC serum glucose: Group 1 (n = 12) mean serum
AC glucose greater than 150 mg/dl; Group 2 (n = 13) mean serum AC glucose
100-150 mg/dl; and Group 3 (n = 14) mean serum AC glucose less than 100
mg/dl. CT scans performed on each patient were studied for the presence of
midline shift and/or ventricular compression, which were interpreted as
evidence of cerebral edema. The three groups were comparable with respect
to mean age, average mean arterial blood pressure and initial infarct size.
Our results show that in Group 1, 42% of the patients died within the first
week following their CVA with clinical evidence of transtentorial
herniation confirmed by CT or autopsy. In contrast, none of the Group 3
patients died and only one showed radiological evidence for cerebral edema.
Group 2 patients showed intermediate mortality and evidence of cerebral
edema. These trends were statistically significant at p less than 0.005. In
addition, the combined hyperglycemic group (1 and 2) had a significantly
higher rate of development of hypodensity on CT (p less than 0.05) than the
normoglycemic group. Our findings suggest that patients with hyperglycemia
in association with their CVA develop more pronounced cerebral edema and
have a worse clinical outcome. Possible pathophysiological mechanisms that
may underlie this observation are discussed.
ARTICLES
The association of hyperglycemia with cerebral edema in stroke
This article has been cited by other articles:
 |
|
 |
|
  R. Garg, A. Chaudhuri, F. Munschauer, and P. Dandona Hyperglycemia, Insulin, and Acute Ischemic Stroke: A Mechanistic Justification for a Trial of Insulin Infusion Therapy Stroke, January 1, 2006; 37(1): 267 - 273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Frontera, A. Fernandez, J. Claassen, M. Schmidt, H. C. Schumacher, K. Wartenberg, R. Temes, A. Parra, N. D. Ostapkovich, and S. A. Mayer Hyperglycemia After SAH: Predictors, Associated Complications, and Impact on Outcome Stroke, January 1, 2006; 37(1): 199 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Part 9: Stroke Circulation, November 29, 2005; 112(22_suppl): III-110 - III-104. [Full Text] [PDF]
|
|
|
|
|
|
T. A. Baird, M. W. Parsons, T. Phanh, K. S. Butcher, P. M. Desmond, B. M. Tress, P. G. Colman, B. R. Chambers, and S. M. Davis Persistent Poststroke Hyperglycemia Is Independently Associated With Infarct Expansion and Worse Clinical Outcome Stroke, September 1, 2003; 34(9): 2208 - 2214. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Aragno, R. Mastrocola, E. Brignardello, M. Catalano, G. Robino, R. Manti, M. Parola, O. Danni, and G. Boccuzzi Dehydroepiandrosterone Modulates Nuclear Factor-{kappa}B Activation in Hippocampus of Diabetic Rats Endocrinology, September 1, 2002; 143(9): 3250 - 3258. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Boysen and H. Christensen Early Stroke: A Dynamic Process Stroke, October 1, 2001; 32(10): 2423 - 2425. [Full Text] [PDF]
|
|
|
|
|
|
A. Davalos, D. Toni, F. Iweins, E. Lesaffre, S. Bastianello, and J. Castillo Neurological Deterioration in Acute Ischemic Stroke : Potential Predictors and Associated Factors in the European Cooperative Acute Stroke Study (ECASS) I Stroke, December 1, 1999; 30(12): 2631 - 2636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Demchuk, L. B. Morgenstern, D. W. Krieger, T. Linda Chi, W. Hu, T. H. Wein, R. J. Hardy, J. C. Grotta, and A. M. Buchan Serum Glucose Level and Diabetes Predict Tissue Plasminogen Activator–Related Intracerebral Hemorrhage in Acute Ischemic Stroke Stroke, January 1, 1999; 30(1): 34 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Anderson, W. K. Tan, H. S. Martin, F. B. Meyer, and P. D. Hurn Effects of Glucose and PaO2 Modulation on Cortical Intracellular Acidosis, NADH Redox State, and Infarction in the Ischemic Penumbra • Editorial Comment Stroke, January 1, 1999; 30(1): 160 - 170. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Cipolla, J. M. Porter, G. Osol, and W. G. Mayhan High Glucose Concentrations Dilate Cerebral Arteries and Diminish Myogenic Tone Through an Endothelial Mechanism Stroke, February 1, 1997; 28(2): 405 - 411. [Abstract] [Full Text]
|
|
|
|
|
|
R. L. Tyson, G. R. Sutherland, and J. Peeling 23Na Nuclear Magnetic Resonance Spectral Changes During and After Forebrain Ischemia in Hypoglycemic, Normoglycemic, and Hyperglycemic Rats Stroke, May 1, 1996; 27(5): 957 - 964. [Abstract] [Full Text]
|
|
|
|
|
|
A. Chamorro, N. Vila, C. Ascaso, A. Saiz, J. Montalvo, P. Alonso, and E. Tolosa Early Prediction of Stroke Severity : Role of the Erythrocyte Sedimentation Rate Stroke, April 1, 1995; 26(4): 573 - 576. [Abstract] [Full Text]
|
|
|
|
|
|
D. S. Warner, M. M. Todd, F. Dexter, P. Ludwig, and A. M. McAllister Temporal Thresholds for Hyperglycemia-Augmented Ischemic Brain Damage in Rats Stroke, April 1, 1995; 26(4): 655 - 660. [Abstract] [Full Text]
|
|