Deans' stroke musings: Predictive value of net water uptake for early neurological deterioration after mechanical thrombectomy in acute ischemic stroke with large vessel occlusion

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, October 13, 2025

Predictive value of net water uptake for early neurological deterioration after mechanical thrombectomy in acute ischemic stroke with large vessel occlusion

Useless. You described a problem, offered NO SOLUTION for preventing early neurological deterioration!

Predictive value of net water uptake for early neurological deterioration after mechanical thrombectomy in acute ischemic stroke with large vessel occlusion

Min Kuang¹^†

Junying Li²^†

Jian Wang²^*

Guangwen Chen¹^*

Chao Luo¹

¹Department of Radiology, West China School of Medicine, Sichuan University, Sichuan University Affiliated Chengdu Second People’s Hospital, Chengdu, China
²Department of Neurology, West China School of Medicine, Sichuan University, Sichuan University Affiliated Chengdu Second People’s Hospital, Chengdu, China

Purpose: To investigate whether Net Water Uptake (NWU) can predict early neurological deterioration (END) after mechanical thrombectomy (MT) in acute ischemic stroke with large vessel occlusion (AIS-LVO).

Materials and methods: We retrospectively analyzed consecutive patients with AIS-LVO who underwent MT. Patients were categorized into the END group and the non-END group based on whether END occurred. NWU was an imaging parameter to quantify the water uptake capacity of brain tissue and measured on admission non-contrast computed tomography (NCCT). Early edema progression rate (EPR) was determined as the ratio of NWU and time from symptom onset to baseline imaging. Then, the baseline characteristics were subsequently collected. Variable and multiple regression analyses were performed to explore independent risk factors for END. Finally, receiver operating characteristic (ROC) curves were constructed to evaluate the predictive value of NWU for END.

Results: A total of 158 patients were included. The median NWU, admission National Institutes of Health Stroke Scale (NIHSS) and EPR in END group was 10.1% (IQR: 6.8–15.4), 16(IQR: 15–19) and 0.087% (IQR: 0.038–0.187). Respectively, the non-END group was 6.8% (IQR: 0–10.9), 13(IQR: 8–17) and 0.043% (IQR: 0–0.096). Compared with the non-END group, the END group had higher NWU (p = 0.004), higher admission NIHSS score (p = 0.001), and higher EPR (p = 0.006); multiple logistic regression showed that NWU (odds ratio [OR], 1.084; 95% confidence interval [CI], 1.004–1.171, p = 0.039) and admission NIHSS score (OR, 1.124; 95%CI, 1.032–1.224; p = 0.007) were independent risk factors for END. ROC curve showed that NWU had a moderate predictive ability for END. The area under the ROC curve (AUC) was 0.665 (95%CI, 0.561–0.770). The AUC of admission NIHSS score was 0.687 (95%CI, 0.698–0.776). NWU combined with admission NIHSS score had the highest predictive value for END, with an AUC of 0.739 (95%CI, 0.648–0.831).

Conclusion: The NWU was an independent predictor of END and increased NWU is associated with END in patients with AIS-LVO after MT. Similarly, the admission NIHSS score was also an independent predictor. The combination of NWU and the admission NIHSS score achieves the strongest predictive ability for END.