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Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic.
Neuroradiology. 2006 Sep; 48(9):685-90.N

Abstract

INTRODUCTION

The aim of this study was to assess regional cerebral blood flow (rCBV) in areas of CT hypoattenuation appearing in the postoperative period in patients treated for aneurysmal subarachnoid hemorrhage (SAH) using xenon-enhanced CT scanning (Xe-CT).

METHODS

We analyzed 15 patients (5 male and 10 female; mean age 49.7+/-12.1 years) with SAH on CT performed on admission to hospital and who showed a low-density area within a well-defined vascular territory on CT scans after clipping or coiling of a saccular aneurysm. All zones of hypoattenuation were larger than 1 cm(2) and showed signs of a mass effect suggesting a subacute phase of evolution. Two aneurysms were detected in two patients. Aneurysms were located in the middle cerebral artery (n=7), in the anterior communicating artery (n=6), in the internal carotid artery (n=3), and in the posterior communicating artery (n=1). Treatments were surgical (n=8), endovascular (n=2) or both (n=1). A total of 36 Xe-CT studies were performed and rCBF values were measured in two different regions of interest (ROI): the low-density area, and an area of normal-appearing brain tissue located symmetrically in the contralateral hemisphere.

RESULTS

rCBF levels were significantly lower in the low-density area than in the contralateral normal-appearing area (P<0.01). In the low-density areas, irreversible ischemia (CBF <10 ml/100 g per minute) was present in 11/36 lesions (30.6%), ischemic penumbra (CBF 10-20 ml/100 g per minute) and oligemia (CBF 20-34 ml/100 g per minute) in 8/36 lesions (22.2%), relative hyperemia (CBF 34-55 ml/100 g per minute) in 7/36 lesions (19.4%), and absolute hyperemia (CBF >55 ml/100 g per minute) in 2/36 lesions (5.6%).

CONCLUSION

Our study confirmed that rCBF is reduced in new low-density lesions related to specific vascular territories. However, only about one-third of the lesions showed rCBF levels consistent with irreversible ischemia and in a relatively high proportion of lesions, rCBF levels indicated penumbral, oligemic and hyperemic areas.

Authors+Show Affiliations

Neuroradiology Unit, Department of Neurosciences, Arcispedale S Anna, Corso della Giovecca 203, 44100, Ferrara, Italy. henryfai@tin.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16804690

Citation

Fainardi, E, et al. "Regional Cerebral Blood Flow Levels as Measured By xenon-CT in Vascular Territorial Low-density Areas After Subarachnoid Hemorrhage Are Not Always Ischemic." Neuroradiology, vol. 48, no. 9, 2006, pp. 685-90.
Fainardi E, Tagliaferri MF, Compagnone C, et al. Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic. Neuroradiology. 2006;48(9):685-90.
Fainardi, E., Tagliaferri, M. F., Compagnone, C., Tanfani, A., Cocciolo, F., Battaglia, R., Frattarelli, M., Pascarella, R., Targa, L., & Chieregato, A. (2006). Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic. Neuroradiology, 48(9), 685-90.
Fainardi E, et al. Regional Cerebral Blood Flow Levels as Measured By xenon-CT in Vascular Territorial Low-density Areas After Subarachnoid Hemorrhage Are Not Always Ischemic. Neuroradiology. 2006;48(9):685-90. PubMed PMID: 16804690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic. AU - Fainardi,E, AU - Tagliaferri,M F, AU - Compagnone,C, AU - Tanfani,A, AU - Cocciolo,F, AU - Battaglia,R, AU - Frattarelli,M, AU - Pascarella,R, AU - Targa,L, AU - Chieregato,A, Y1 - 2006/06/28/ PY - 2005/06/28/received PY - 2006/04/10/accepted PY - 2006/6/29/pubmed PY - 2007/1/31/medline PY - 2006/6/29/entrez SP - 685 EP - 90 JF - Neuroradiology JO - Neuroradiology VL - 48 IS - 9 N2 - INTRODUCTION: The aim of this study was to assess regional cerebral blood flow (rCBV) in areas of CT hypoattenuation appearing in the postoperative period in patients treated for aneurysmal subarachnoid hemorrhage (SAH) using xenon-enhanced CT scanning (Xe-CT). METHODS: We analyzed 15 patients (5 male and 10 female; mean age 49.7+/-12.1 years) with SAH on CT performed on admission to hospital and who showed a low-density area within a well-defined vascular territory on CT scans after clipping or coiling of a saccular aneurysm. All zones of hypoattenuation were larger than 1 cm(2) and showed signs of a mass effect suggesting a subacute phase of evolution. Two aneurysms were detected in two patients. Aneurysms were located in the middle cerebral artery (n=7), in the anterior communicating artery (n=6), in the internal carotid artery (n=3), and in the posterior communicating artery (n=1). Treatments were surgical (n=8), endovascular (n=2) or both (n=1). A total of 36 Xe-CT studies were performed and rCBF values were measured in two different regions of interest (ROI): the low-density area, and an area of normal-appearing brain tissue located symmetrically in the contralateral hemisphere. RESULTS: rCBF levels were significantly lower in the low-density area than in the contralateral normal-appearing area (P<0.01). In the low-density areas, irreversible ischemia (CBF <10 ml/100 g per minute) was present in 11/36 lesions (30.6%), ischemic penumbra (CBF 10-20 ml/100 g per minute) and oligemia (CBF 20-34 ml/100 g per minute) in 8/36 lesions (22.2%), relative hyperemia (CBF 34-55 ml/100 g per minute) in 7/36 lesions (19.4%), and absolute hyperemia (CBF >55 ml/100 g per minute) in 2/36 lesions (5.6%). CONCLUSION: Our study confirmed that rCBF is reduced in new low-density lesions related to specific vascular territories. However, only about one-third of the lesions showed rCBF levels consistent with irreversible ischemia and in a relatively high proportion of lesions, rCBF levels indicated penumbral, oligemic and hyperemic areas. SN - 0028-3940 UR - https://www.unboundmedicine.com/medline/citation/16804690/Regional_cerebral_blood_flow_levels_as_measured_by_xenon_CT_in_vascular_territorial_low_density_areas_after_subarachnoid_hemorrhage_are_not_always_ischemic_ L2 - https://dx.doi.org/10.1007/s00234-006-0111-2 DB - PRIME DP - Unbound Medicine ER -