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Global and focal cerebral perfusion after aneurysmal subarachnoid hemorrhage in relation with delayed cerebral ischemia.
Neuroradiology. 2008 Sep; 50(9):813-20.N

Abstract

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.

Authors+Show Affiliations

Department of Radiology, University Medical Center Utrecht, GA Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18548240

Citation

Rijsdijk, M, et al. "Global and Focal Cerebral Perfusion After Aneurysmal Subarachnoid Hemorrhage in Relation With Delayed Cerebral Ischemia." Neuroradiology, vol. 50, no. 9, 2008, pp. 813-20.
Rijsdijk M, van der Schaaf IC, Velthuis BK, et al. Global and focal cerebral perfusion after aneurysmal subarachnoid hemorrhage in relation with delayed cerebral ischemia. Neuroradiology. 2008;50(9):813-20.
Rijsdijk, M., van der Schaaf, I. C., Velthuis, B. K., Wermer, M. J., & Rinkel, G. J. (2008). Global and focal cerebral perfusion after aneurysmal subarachnoid hemorrhage in relation with delayed cerebral ischemia. Neuroradiology, 50(9), 813-20. https://doi.org/10.1007/s00234-008-0416-4
Rijsdijk M, et al. Global and Focal Cerebral Perfusion After Aneurysmal Subarachnoid Hemorrhage in Relation With Delayed Cerebral Ischemia. Neuroradiology. 2008;50(9):813-20. PubMed PMID: 18548240.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Global and focal cerebral perfusion after aneurysmal subarachnoid hemorrhage in relation with delayed cerebral ischemia. AU - Rijsdijk,M, AU - van der Schaaf,I C, AU - Velthuis,B K, AU - Wermer,M J, AU - Rinkel,G J E, Y1 - 2008/06/12/ PY - 2007/12/06/received PY - 2008/05/14/accepted PY - 2008/6/13/pubmed PY - 2009/1/14/medline PY - 2008/6/13/entrez SP - 813 EP - 20 JF - Neuroradiology JO - Neuroradiology VL - 50 IS - 9 N2 - 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. SN - 0028-3940 UR - https://www.unboundmedicine.com/medline/citation/18548240/Global_and_focal_cerebral_perfusion_after_aneurysmal_subarachnoid_hemorrhage_in_relation_with_delayed_cerebral_ischemia_ L2 - https://dx.doi.org/10.1007/s00234-008-0416-4 DB - PRIME DP - Unbound Medicine ER -