Early Cerebral Circulatory Disturbance in Patients Suffering Subarachnoid Hemorrhage Prior to the Delayed Cerebral Vasospasm Stage: Xenon Computed Tomography and Perfusion Computed Tomography Study
| Autor: | Mitsuru Honda, Ryo Ichibayashi, Kyosuke Yokota, Katsunori Yoshihara, Shigeru Sase, Hiroyuki Uekusa, Taichi Kishi, Yoshihito Sakata, Yoshikatsu Seiki, Hiroyuki Masuda |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Subarachnoid hemorrhage Perfusion Imaging Ischemia Cerebral circulation Cerebral vasospasm medicine Humans Vasospasm Intracranial Prospective Studies cardiovascular diseases Aged Aged 80 and over business.industry Glasgow Outcome Scale Vasospasm Middle Aged Subarachnoid Hemorrhage medicine.disease Early Diagnosis Cerebral blood flow Cerebrovascular Circulation Anesthesia Female Surgery Neurology (clinical) Tomography X-Ray Computed business Perfusion Xenon Radioisotopes circulatory and respiratory physiology |
| Zdroj: | Neurologia medico-chirurgica. 52:488-494 |
| ISSN: | 1349-8029 0470-8105 |
| DOI: | 10.2176/nmc.52.488 |
| Popis: | Subarachnoid hemorrhage (SAH) causes dynamic changes in cerebral blood flow (CBF), and results in delayed ischemia due to vasospasm, and early perfusion deficits before delayed cerebral vasospasm (CVS). The present study examined the severity of cerebral circulatory disturbance during the early phase before delayed CVS and whether it can be used to predict patient outcome. A total of 94 patients with SAH underwent simultaneous xenon computed tomography (CT) and perfusion CT to evaluate cerebral circulation on Days 1-3. Cerebral blood flow (CBF) was measured using xenon CT and the mean transit time (MTT) using perfusion CT and calculated cerebral blood volume (CBV). Outcome was evaluated with the Glasgow Outcome Scale (good recovery [GR], moderate disability [MD], severe disability [SD], vegetative state [VS], or death [D]). Hunt and Hess (HH) grade II patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. HH grade III patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. Patients with favorable outcome (GR or MD) had significantly higher CBF and lower MTT than those with unfavorable outcome (SD, VS, or D). Discriminant analysis of these parameters could predict patient outcome with a probability of 74.5%. Higher HH grade on admission was associated with decreased CBF and CBV and prolonged MTT. CBF reduction and MTT prolongation before the onset of delayed CVS might influence the clinical outcome of SAH. These parameters are helpful for evaluating the severity of SAH and predicting the outcomes of SAH patients. |
| Databáze: | OpenAIRE |
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