BackgroundMidline shift (MLS) is troublesome problem that may occur in patients with a large infarct core (LIC) and may be related to the baseline infarct core volume. The purpose of this study was to explore the relationship between baseline infarct core volume and early MLS presence.Materials and methodsPatients with acute intracranial large artery occlusion and a pretreatment relative cerebral blood flow (rCBF) 40 ml based on an rCBF < 15% showed good predictive value for early MLS occurrence.