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Quantitative perihematomal blood flow in spontaneous intracerebral hemorrhage predicts in-hospital functional outcome.
Stroke. 2007 Feb; 38(2):319-24.S

Abstract

BACKGROUND AND PURPOSE

Few data on xenon computed tomography-based quantitative cerebral blood flow (CBF) in spontaneous intracerebral hemorrhage have been reported. We correlated perihematomal CBF in a retrospective series of 42 subacute spontaneous intracerebral hemorrhage patients undergoing xenon computed tomography with in-hospital discharge status and mortality.

METHODS

We calculated 3 area-weighted mean CBF values: (1) within the computed tomography-visible rim of perihematomal edema, (2) within a 1-cm marginal radius around the hematoma, and (3) all cortical regions of interest immediately adjacent to the hematoma. Primary outcomes were in-hospital mortality and discharge status (ordinally as 0=home, 1=acute rehabilitation, 2=nursing home, 3=death). Discharge status was used as a surrogate for in-hospital functional outcome.

RESULTS

Median hematoma volume was 14.4 cm(3) (range, 2 to 70). Median perihematomal (low-attenuation rim) CBF was 21.9 cm(3).100 g(-1).min(-1) (range, 6.1 to 81.1), and the median 1-cm marginal radius CBF was 26.8 cm(3).100 g(-1).min(-1) (range, 10.8 to 72.8). The median regional cortical CBF was 26.7 cm(3).100 g(-1).min(-1) (range, 6.9 to 72.6). Eight patients had 1-cm marginal radius or regional cortical CBF values <20 cm(3).100 g(-1).min(-1). Hematoma volume (odds ratio [OR], 1.68 per 10-cm(3) volume; P=0.036) and intraventricular hemorrhage (OR, 1.88 per grade of intraventricular hemorrhage; P=0.036) predicted mortality. Two CBF measures, hydrocephalus, and IVH predicted poor in-hospital functional outcome in bivariate analysis. Each CBF measure (OR, 0.34 to 0.43; P<0.001 to 0.003) and intraventricular hemorrhage (OR, 3.42; P<0.001) predicted in-hospital functional outcome in multivariable analyses.

CONCLUSIONS

Most spontaneous intracerebral hemorrhage patients lack perihematomal penumbra. Perihematomal CBF independently predicts in-hospital discharge status but not in-hospital mortality. Further studies are warranted to determine whether perihematomal CBF predicts long-term functional outcomes.

Authors+Show Affiliations

Department of Neurology and University of Pittsburgh Medical Center Stroke Institute, University of Pittsburgh, Pittsburgh, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17194883

Citation

Tayal, Ashis H., et al. "Quantitative Perihematomal Blood Flow in Spontaneous Intracerebral Hemorrhage Predicts In-hospital Functional Outcome." Stroke, vol. 38, no. 2, 2007, pp. 319-24.
Tayal AH, Gupta R, Yonas H, et al. Quantitative perihematomal blood flow in spontaneous intracerebral hemorrhage predicts in-hospital functional outcome. Stroke. 2007;38(2):319-24.
Tayal, A. H., Gupta, R., Yonas, H., Jovin, T., Uchino, K., Hammer, M., Wechsler, L., & Gebel, J. M. (2007). Quantitative perihematomal blood flow in spontaneous intracerebral hemorrhage predicts in-hospital functional outcome. Stroke, 38(2), 319-24.
Tayal AH, et al. Quantitative Perihematomal Blood Flow in Spontaneous Intracerebral Hemorrhage Predicts In-hospital Functional Outcome. Stroke. 2007;38(2):319-24. PubMed PMID: 17194883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative perihematomal blood flow in spontaneous intracerebral hemorrhage predicts in-hospital functional outcome. AU - Tayal,Ashis H, AU - Gupta,Rishi, AU - Yonas,Howard, AU - Jovin,Tudor, AU - Uchino,Ken, AU - Hammer,Maxim, AU - Wechsler,Lawrence, AU - Gebel,James M, Y1 - 2006/12/28/ PY - 2006/12/30/pubmed PY - 2007/3/14/medline PY - 2006/12/30/entrez SP - 319 EP - 24 JF - Stroke JO - Stroke VL - 38 IS - 2 N2 - BACKGROUND AND PURPOSE: Few data on xenon computed tomography-based quantitative cerebral blood flow (CBF) in spontaneous intracerebral hemorrhage have been reported. We correlated perihematomal CBF in a retrospective series of 42 subacute spontaneous intracerebral hemorrhage patients undergoing xenon computed tomography with in-hospital discharge status and mortality. METHODS: We calculated 3 area-weighted mean CBF values: (1) within the computed tomography-visible rim of perihematomal edema, (2) within a 1-cm marginal radius around the hematoma, and (3) all cortical regions of interest immediately adjacent to the hematoma. Primary outcomes were in-hospital mortality and discharge status (ordinally as 0=home, 1=acute rehabilitation, 2=nursing home, 3=death). Discharge status was used as a surrogate for in-hospital functional outcome. RESULTS: Median hematoma volume was 14.4 cm(3) (range, 2 to 70). Median perihematomal (low-attenuation rim) CBF was 21.9 cm(3).100 g(-1).min(-1) (range, 6.1 to 81.1), and the median 1-cm marginal radius CBF was 26.8 cm(3).100 g(-1).min(-1) (range, 10.8 to 72.8). The median regional cortical CBF was 26.7 cm(3).100 g(-1).min(-1) (range, 6.9 to 72.6). Eight patients had 1-cm marginal radius or regional cortical CBF values <20 cm(3).100 g(-1).min(-1). Hematoma volume (odds ratio [OR], 1.68 per 10-cm(3) volume; P=0.036) and intraventricular hemorrhage (OR, 1.88 per grade of intraventricular hemorrhage; P=0.036) predicted mortality. Two CBF measures, hydrocephalus, and IVH predicted poor in-hospital functional outcome in bivariate analysis. Each CBF measure (OR, 0.34 to 0.43; P<0.001 to 0.003) and intraventricular hemorrhage (OR, 3.42; P<0.001) predicted in-hospital functional outcome in multivariable analyses. CONCLUSIONS: Most spontaneous intracerebral hemorrhage patients lack perihematomal penumbra. Perihematomal CBF independently predicts in-hospital discharge status but not in-hospital mortality. Further studies are warranted to determine whether perihematomal CBF predicts long-term functional outcomes. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/17194883/Quantitative_perihematomal_blood_flow_in_spontaneous_intracerebral_hemorrhage_predicts_in_hospital_functional_outcome_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000254492.35504.db?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -