Prediction of persistent ventricular dilation by initial ventriculomegaly and clot volume in a porcine model.

Autor:	Lai GY; 1Department of Neurological Surgery, McGaw Medical Center of Northwestern University, Chicago, Illinois.; 2Center for Image-Guided Innovation and Therapeutic Intervention and., Chu Kwan W; 2Center for Image-Guided Innovation and Therapeutic Intervention and.; 3Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada., Piorkowska K; 2Center for Image-Guided Innovation and Therapeutic Intervention and., Wagner MW; 4Division of Neuroradiology, The Hospital for Sick Children, Toronto, Ontario, Canada; and., Jamshidi P; 5Department of Pathology, McGaw Medical Center of Northwestern University, Chicago, Illinois., Ertl-Wagner B; 3Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada.; 4Division of Neuroradiology, The Hospital for Sick Children, Toronto, Ontario, Canada; and., Looi T; 2Center for Image-Guided Innovation and Therapeutic Intervention and.; 3Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada., Waspe AC; 2Center for Image-Guided Innovation and Therapeutic Intervention and.; 3Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada., Drake JM; 2Center for Image-Guided Innovation and Therapeutic Intervention and.; 3Division of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2021 Nov 19; Vol. 29 (3), pp. 237-244. Date of Electronic Publication: 2021 Nov 19 (Print Publication: 2022).
DOI:	10.3171/2021.9.PEDS2190
Abstrakt:	Objective: While intraventricular hemorrhage (IVH) is associated with posthemorrhagic ventricular dilation (PHVD), not all infants affected by high-grade IVH develop PHVD. The authors aimed to determine clot-associated predictors of PHVD in a porcine model by varying the amount and rate of direct intraventricular injection of whole autologous blood. Methods: Seven 1-week-old piglets underwent craniectomy and injection of autologous blood into the right lateral ventricle. They survived for a maximum of 28 days. MRI was performed prior to injection, immediately postoperatively, and every 7 days thereafter. T1-weighted, T2-weighted, and susceptibility-weighted imaging (SWI) sequences were used to segment ventricular and clot volumes. Spearman correlations were used to determine the relationship between blood and clot volumes and ventricular volumes over time. Results: The maximum ventricular volume was up to 12 times that of baseline. One animal developed acute hydrocephalus on day 4. All other animals survived until planned endpoints. The interaction between volume of blood injected and duration of injection was significantly associated with clot volume on the postoperative scan (p = 0.003) but not the amount of blood injected alone (p = 0.38). Initial postoperative and day 7 clot volumes, but not volume of blood injected, were correlated with maximum (p = 0.007 and 0.014) and terminal (p = 0.014 and 0.036) ventricular volumes. Initial postoperative ventricular volume was correlated with maximum and terminal ventricular volume (p = 0.007 and p = 0.014). Conclusions: Initial postoperative, maximum, and terminal ventricular dilations were associated with the amount of clot formed, rather than the amount of blood injected. This supports the hypothesis that PHVD is determined by clot burden rather than the presence of blood products and allows further testing of early clot lysis to minimize PHVD risk.
Databáze:	MEDLINE
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