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Global and focal cerebral perfusion after aneurysmal... (2008) Open access

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Titel Global and focal cerebral perfusion after aneurysmal subarachnoid hemorrhage in relation with delayed cerebral ischemia
Gepubliceerd in Neuroradiology. ISSN 1432-1920.
Auteur Rijsdijk, M.; Schaaf, I.C. van der; Velthuis, B.K.; Wermer, M.J.H.; Rinkel, G.J.E.
Datum 2008
Trefwoord(en) Subarachnoid hemorrhage, Brain ischemia, CT perfusion, Cerebral autoregulation
Taal Engels
Type Artikel
Uitgever Springer
Samenvatting Introduction: The pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is unclear. We assessed whether DCI relates to focal or global cerebral perfusion on admission and on follow-up imaging. Materials and methods: Twenty-seven SAH patients underwent computed tomography (CT) perfusion (CTP) on admission and at clinical deterioration or 1 week after admission in clinically stable patients. We compared global and focal (least perfused territory) perfusion in patients with DCI (n=12), clinically stable patients (n=7), and patients with non-DCI-related deterioration (n=8). Results: Global cerebral blood flow (CBF) increased on follow-up: 29% (95% confidence interval (CI) 15% to 43%) in patients with DCI, 12% (95%CI −1% to 25%) in stable patients, and 20% (95%CI 4% to 36%) in patients with non- DCI-related deterioration. Focal CBF decreased in patients with DCI, (−23%; 95%CI −58% to 12%) but increased in patients with non-DCI-related deterioration (23%; 95%CI −26%to 55%) and stable patients (7%; 95%CI −30%to 45%). On follow-up, global CBF was lower in patients with DCI (70.0 ml per 100 g/min) than in clinically stable patients (81.6; difference 11.6; 95%CI 0.8 to 22.5 ml per 100 g/min) but comparable to patients with non-DCI-related deterioration (67.6; difference −2.4; 95%CI −11.9 to 7.2 ml per 100 g/min). Focal CBF was lower in patients with DCI (30.7) than in clinically stable patients (53.6; difference 22.9; 95%CI 5.1 to 40.6 ml per 100 g/min) and patients with non-DCI-related deterioration (46.6; difference 15.9; 95%CI −2.6 to 28.4 ml per 100 g/min) Conclusion: Our results suggest that DCI is more likely a focal than a global process.
Publicatie http://dspace.library.uu.nl/handle/1874/29975
Persistent Identifier URN:NBN:NL:UI:10-29975
Metadata XML
Repository Universiteit Utrecht

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