Author(s)

Namory Camara^1*, Mohamed Tafsir Diallo², Malé Doré², Mohamed Lamine Condé², Karimka Diawara², Djènè Keita¹, Fodé Abass Cissé^1,2

¹Simbaya Institute of Neurology, Conakry, Guinea.
²Department of Neurology, Conakry University Hospital, Conakry, Guinea.

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 < 9. Epidemiological, clinical and prognostic variables were listed. Any p-value < 0.05 was considered statistically significant. 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.

Malignant Sylvian Infarction, Respiratory Distress, Aspiration Pneumonia, Cerebral Herniation, INS

Camara, N. , Diallo, M. , Doré, M. , Condé, M. , Diawara, K. , Keita, D. and Cissé, F. (2025) Malignant Sylvian Infarction: Epidemiological, Clinical and Prognostic Aspects at the Institute of Neurology of Simbaya, Conakry. World Journal of Neuroscience, 15, 84-94. doi: 10.4236/wjns.2025.151008.