CT perfusion mapping of hemodynamic disturbances associated to acute spontaneous intracerebral hemorrhage

Fainardi, Enrico; Borrelli, Massimo; Saletti, Andrea; Schivalocchi, Roberta; Azzini, Cristiano; Cavallo, Michele Alessandro; Ceruti, Stefano; Tamarozzi, Riccardo; Chieregato, Arturo

doi:10.1007/s00234-008-0402-x

Cited by 39 publications

(38 citation statements)

References 31 publications

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“…When the threshold value of perihematma CBV was 1.24 ml·100 g −1 , the sensitivity was 66.67% and the specificity was This study described the descriptive analysis of quantitative perihematomal hypoperfusion assessed by CTP in acute shICH patients. According to our data, there was significantly decreased CBV, CBF, and prolonged MTT in the perihematomal zone against contralateral hemisphere, which was similar to most of clinical results of recent years [6][7][8]. Currently it was considered that hypoperfusion surrounding the hematoma was mostly due Table 3.…”

Section: Discussionsupporting

confidence: 67%

CT Perfusion Imaging Predicts One-Month Outcome in Patients with Acute Spontaneous Hypertensive Intracerebral Hemorrhage

Xu¹,

Chen²,

Wang³

et al. 2013

ACT

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Purpose: Little is known about the relationship between perihematomal perfusion parameters in acute spontaneous hypertensive intracerebral hemorrhage patients and recent outcome. The purpose of this study was to evaluate the relationship between the perfusion parameters of the perihematomal brain tissue and the recent prognosis of patients with acute spontaneous hypertensive intracerebral hemorrhage (shICH) using CT perfusion (CTP) imaging. Methods: Twenty-six patients with clinical and CT diagnosed supratentorial shICH received CTP scanning within 8 -19 h after symptom onset. At the maximum levels of the hematoma, cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of perihematomal area (isodense within 1cm rim of perilesion area on plain CT) and contralateral mirrored hemisphere were measured, and rCBF, rCBV, rMTT were calculated (ipsilateral/contralateral). The one-month follow-up in accordance with daily living table (Barthel index, BI) by telephone was recorded. Results: The CBV, CBF, and MTT values of perihematoma area were (1.61 ± 1.53) ml·100 g , and (9.12 ± 2.57) s, respectively. There was significantly decreased CBV, CBF, and prolonged MTT in the perihematomal zone against contralateral hemisphere (Z CBV = −2.603, Z CBF = −4.178, t MTT = 4.747, all P < 0.05). Wilcoxon ranksum test displayed that perihematomal absolute values of CBV, CBF were indicative of recent prognosis (Z CBV = −3.40, Z CBF = −2.98, both P < 0.01), but MTT, rCBF, rCBV, rMTT showed no correlation (all P > 0.05). The areas under ROC curve (AUC) of CBV, CBF were 0.897, 0.848, respectively. When the threshold value of perihematma CBV was 1.24 ml·100 g −1 , the sensitivity was 66.67% and the specificity was 100%, the threshold value of CBF was 8.44 ml·100 g), the sensitivity was 100% and the specificity was 72.70%. Conclusion: CTP can predict the recent prognosis of shICH patients. Within a certain range, the recent prognosis declines with the increment of CBV CBF values.

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Section: Discussionsupporting

confidence: 67%

CT Perfusion Imaging Predicts One-Month Outcome in Patients with Acute Spontaneous Hypertensive Intracerebral Hemorrhage

Xu¹,

Chen²,

Wang³

et al. 2013

ACT

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“…Additionally, the majority of previous PCT studies focused on distinctively smaller intracerebral hematomas (range of mean hematoma volume, 17.5-26.8 mL) compared with mean hematoma volumes in our patient population (68.5Ϯ45.5 mL SD). 5,10,20 There are several explanations for our findings. T max , the parameter most sensitive to the course of cerebral perfusion disturbances in our study, is strongly influenced by intracranial pressure and might be more sensitive than mean transit time for hemodynamic assessment in SICH.…”

Section: Discussionmentioning

confidence: 54%

Perfusion CT in Patients With Spontaneous Lobar Intracerebral Hemorrhage

Etminan

Beseoglu

Turowski

et al. 2012

Stroke

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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. (Stroke. 2012;43:759-763.)

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“…Interestingly, in mice injured with ICH, though there was a profound decrease in CBF by laser doppler flowmetry, we did not demonstrate any difference in CBF with nesiritide treatment, despite finding an improvement in outcome. Presumably this is due to the lack of the existence of a perihematomal penumbra in this disease state (Fainardi et al, 2008;Orakcioglu et al, 2008), but may FIG. 8.…”

Section: Figmentioning

confidence: 99%

Brain Natriuretic Peptide Improves Long-Term Functional Recovery after Acute CNS Injury in Mice

James

Wang

Venkatraman

et al. 2010

Journal of Neurotrauma

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There is emerging evidence to suggest that brain natriuretic peptide (BNP) is elevated after acute brain injury, and that it may play an adaptive role in recovery through augmentation of cerebral blood flow (CBF). Through a series of experiments, we tested the hypothesis that the administration of BNP after different acute mechanisms of central nervous system (CNS) injury could improve functional recovery by improving CBF. C57 wild-type mice were exposed to either pneumatic-induced closed traumatic brain injury (TBI) or collagenase-induced intracerebral hemorrhage (ICH). After injury, either nesiritide (hBNP) (8 mg=kg) or normal saline were administered via tail vein injection at 30 min and 4 h. The mice then underwent functional neurological testing via rotorod latency over the following 5 days and neurocognitive testing via Morris water maze testing on days 24-28. Cerebral blood flow (CBF) was assessed by laser Doppler from 25 to 90 min after injury. After ICH, mRNA polymerase chain reaction (PCR) and histochemical staining were performed during the acute injury phase (<24 h) to determine the effects on inflammation. Following TBI and ICH, administration of hBNP was associated with improved functional performance as assessed by rotorod and Morris water maze latencies ( p < 0.01). CBF was increased ( p < 0.05), and inflammatory markers (TNF-a and IL-6; p < 0.05), activated microglial (F4=80; p < 0.05), and neuronal degeneration (Fluoro-Jade B; p < 0.05) were reduced in mice receiving hBNP. hBNP improves neurological function in murine models of TBI and ICH, and was associated with enhanced CBF and downregulation of neuroinflammatory responses. hBNP may represent a novel therapeutic strategy after acute CNS injury.

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CT perfusion mapping of hemodynamic disturbances associated to acute spontaneous intracerebral hemorrhage

Cited by 39 publications

References 31 publications

CT Perfusion Imaging Predicts One-Month Outcome in Patients with Acute Spontaneous Hypertensive Intracerebral Hemorrhage

CT Perfusion Imaging Predicts One-Month Outcome in Patients with Acute Spontaneous Hypertensive Intracerebral Hemorrhage

Perfusion CT in Patients With Spontaneous Lobar Intracerebral Hemorrhage

Brain Natriuretic Peptide Improves Long-Term Functional Recovery after Acute CNS Injury in Mice

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