Perfusion CT in patients with spontaneous lobar intracerebral hemorrhage: effect of surgery on perihemorrhagic perfusion.

Abstract:

BACKGROUND AND PURPOSE:The aim of the present study was to investigate cerebral hemodynamics in patients requiring surgical treatment for lobar intracerebral hemorrhage. METHODS:Twenty patients who underwent surgery to remove a lobar spontaneous intracerebral hemorrhage were scanned before and after surgery using perfusion CT mapping. Mean transit time, time to peak of the residue function, cerebral blood volume, and cerebral blood flow were measured in 4 defined regions of interest. RESULTS:Preoperatively, time to peak of the residue function, cerebral blood volume, and cerebral blood flow were significantly impaired in the perihemorrhagic zone as compared with the ipsilateral and contralateral hemisphere. Perihematomal perfusion improved significantly after clot evacuation and there was no difference in time to peak of the residue function, cerebral blood flow, and cerebral blood volume values between the perihemorrhagic zone and ipsilateral as well as contralateral hemisphere after surgical treatment. CONCLUSIONS:Our findings illustrate distinct perihemorrhagic perfusion impairments in a selected patient population with lobar intracerebral hemorrhage as evident by impaired time to peak of the residue function, cerebral blood flow, and cerebral blood volume and their improvement after early surgical treatment. Whether these early improvements in hemodynamic measurements may influence secondary neuronal injury and ultimately clinical outcome, as opposed to the natural course of spontaneous intracerebral hemorrhage remains unclear.

journal_name

Stroke

journal_title

Stroke

authors

Etminan N,Beseoglu K,Turowski B,Steiger HJ,Hänggi D

doi

10.1161/STROKEAHA.111.616730

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

759-63

issue

3

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.111.616730

journal_volume

43

pub_type

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