恶性肿胀是一种致命的并发症，可在占位性小脑梗塞中突然发生。我们的目的是建立预测小脑梗死恶性肿胀的标志物。我们回顾性分析了2014年至2020年间在我院接受治疗的脑卒中患者的数据。恶性肿胀被定义为后颅窝的占位效应，伴随着小脑梗塞恶性肿胀的减少。由于脑干受压和/或阻塞性脑积水而导致意识丧失。对多个变量进行统计分析，以确定恶性肿胀的预测因素。在 7284 名中风患者中，我们确定了 487 名患者患有小脑梗塞。 93 例患有占位性小脑梗塞的患者适合进行分析。 93 名患者中有 33 名 (35.5%) 出现恶性肿胀。多变量分析显示，梗塞体积是主要预测因子，与恶性肿胀的发生独立相关，梗塞体积截止值为 38 cm3 与肿胀率 >50% 相关（OR 32.0，p<0.001）。入院时 NIHSS（美国国立卫生研究院卒中量表）评分较高（中位 NIHSS 12 vs 4，OR 1.078；p=0.008）并且存在额外脑干梗塞（51.5% vs 16.7%， OR 5.312；p=0.013）在单变量分析中与恶性肿胀的发生相关。33 例恶性肿胀中的 13 例（39.4%）发生在超过 3 天后。梗塞体积是空间恶性肿胀的关键预测因素。占位性小脑梗塞。由于许多恶性肿胀病例发生在超过 72 小时后，我们主张延长神经学监测。© 作者（或其雇主）2024。根据 CC BY-NC 允许重复使用。禁止商业再利用。请参阅权利和权限。英国医学杂志出版。

Malignant swelling is a fatal complication that can occur abruptly in space-occupying cerebellar infarction. We aimed to establish markers that predict malignant swelling in cerebellar infarction.We retrospectively analysed data of stroke patients who were treated in our hospital between 2014 and 2020. Malignant swelling was defined as a mass effect in the posterior cranial fossa, accompanied by a decrease in consciousness due to compression of the brainstem and/or the development of obstructive hydrocephalus. Statistical analyses were performed on multiple variables to identify predictors of malignant swelling.Among 7284 stroke patients, we identified 487 patients with an infarct in the cerebellum. 93 patients were suitable for analysis having space-occupying cerebellar infarction. 33 of 93 (35.5%) patients developed malignant swelling.Multivariable analysis revealed infarct volume as the main predictor being independently associated with the development of malignant swelling with a cut-off infarct volume of 38 cm3 being associated with a swelling rate of >50% (OR 32.0, p<0.001).Higher NIHSS (National Institutes of Health Stroke Scale) score on admission (median NIHSS 12 vs 4, OR 1.078; p=0.008) and the presence of additional brainstem infarction (51.5% vs 16.7%, OR 5.312; p=0.013) were associated with the development of malignant swelling in univariate analyses.13 of 33 (39.4%) cases of malignant swellings occurred after more than 3 days.Infarct volume was the key significant predictor of malignant swelling in space-occupying cerebellar infarction. With many cases of malignant swelling occurring after more than 72 hours, we advocate prolonged neurological monitoring.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.