2024-03-28T11:20:55Zhttps://dspace.library.uu.nl/oai/dareoai:dspace.library.uu.nl:1874/299752014-04-25T07:43:45Zcom_1874_296827com_1874_298213col_1874_296828col_1874_298214dare
URN:NBN:NL:UI:10-1874-29975
2014-04-25T09:43:45.0Z
https://dspace.library.uu.nl/handle/1874/29975
Global and focal cerebral perfusion after aneurysmal subarachnoid hemorrhage in relation with delayed cerebral ischemia
Rijsdijk
M.
aut
Schaaf
I.C. van der
aut
Velthuis
B.K.
aut
Wermer
M.J.H.
aut
Rinkel
G.J.E.
aut
text
info:eu-repo/semantics/Article
2008
en
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.
Subarachnoid hemorrhage
Brain ischemia
CT perfusion
Cerebral autoregulation
Geneeskunde
Neuroradiology
Springer
2008
1432-1920
1874/29975
337907501
29133489X
176956301
085712000
2014-04-25T09:43:45.0Z
http://purl.org/eprint/accessRights/OpenAccess