Defining cutoff values for early prediction of delayed cerebral ischemia after subarachnoid hemorrhage by CT perfusion

Malinova, Vesna; Tsogkas, Ioannis; Behme, Daniel; Rohde, Veit; Psychogios, Marios

doi:10.1007/s10143-019-01082-8

Cited by 18 publications

(10 citation statements)

References 31 publications

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“…The developed method has lower efficiency in feature analysis and feature relation analysis. Malinova et al [ 34 ] applied statistical analysis in the CT images to predict the SAH. The CT perfusion data were used to evaluate the performance of the developed statistical model.…”

Section: Review Of Sah Prediction Modelsmentioning

confidence: 99%

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Prediction and Risk Assessment Models for Subarachnoid Hemorrhage: A Systematic Review on Case Studies

Sengupta

Alzbutas

2022

BioMed Research International

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Subarachnoid hemorrhage (SAH) is one of the major health issues known to society and has a higher mortality rate. The clinical factors with computed tomography (CT), magnetic resonance image (MRI), and electroencephalography (EEG) data were used to evaluate the performance of the developed method. In this paper, various methods such as statistical analysis, logistic regression, machine learning, and deep learning methods were used in the prediction and detection of SAH which are reviewed. The advantages and limitations of SAH prediction and risk assessment methods are also being reviewed. Most of the existing methods were evaluated on the collected dataset for the SAH prediction. In some researches, deep learning methods were applied, which resulted in higher performance in the prediction process. EEG data were applied in the existing methods for the prediction process, and these methods demonstrated higher performance. However, the existing methods have the limitations of overfitting problems, imbalance data problems, and lower efficiency in feature analysis. The artificial neural network (ANN) and support vector machine (SVM) methods have been applied for the prediction process, and considerably higher performance is achieved by using this method.

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Section: Review Of Sah Prediction Modelsmentioning

confidence: 99%

“…The sample images of RSNA intracranial hemorrhage is shown in Figure 4 . The study [ 34 ] collected 128 CT images from the Siemens Healthcare Sector, Forchheim, Germany. The study [ 35 ] collected CT images of 40 patients from Keio University Hospital between 2015 and August 2018.…”

Section: Review Of Sah Prediction Modelsmentioning

confidence: 99%

Prediction and Risk Assessment Models for Subarachnoid Hemorrhage: A Systematic Review on Case Studies

Sengupta

Alzbutas

2022

BioMed Research International

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“…Traditional examination cannot accurately reflect the state of cerebral microcirculation; noninvasive CT perfusion imaging can be through blood volume (CBV), blood flow (CBF), mean transit time (MTT), time to peak (TTP), and other parameters, showing the whole brain microcirculation in different lobes, especially ischemic brain tissue. In this study, CT whole brain perfusion imaging technology was used to simultaneously measure the changes of influencing factors such as ET-1, and the pathological changes of brain tissue were compared to observe the changes of brain microcirculation [ 6 , 7 ]. Further understanding of the mechanism of SAH, with a view to clinical treatment of microcirculation changes as the basis for SAH treatment, reduces the mortality and disability rate.…”

Section: Introductionmentioning

confidence: 99%

The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage

Qin

Wang

Xie

et al. 2022

Journal of Healthcare Engineering

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Subarachnoid hemorrhage (SAH), especially aneurysmal subarachnoid hemorrhage, is a serious cerebrovascular disease with high mortality and morbidity. However, there is no effective treatment in clinics. In recent years, more and more studies have shown that early brain injury (EBI) may be an important reason for poor prognosis of SAH. Explore the mechanism of early brain injury after subarachnoid hemorrhage (SAH). In this study, 20 male New Zealand white rabbits were selected and divided into the experimental group and sham operation group, with 10 rabbits in each group. The neurobehavioral scores, food intake, and cerebral perfusion parameters, cerebral blood volume (CBV), cerebral blood flow velocity (CBF), ET-1, IL-1, and IL-6, in rabbit plasma were compared. The food intake scores and neurological dysfunction scores of the experimental group at 1 h, 6 h, 24 h, and 72 h after modeling were higher than those of the sham operation group, which had a statistical significance ( P < 0.05 ). The dysfunction scores all showed a gradual decrease; the CBV and CBF values of the experimental group at 1 h, 6 h, 24 h, and 72 h after modeling were all lower than those of the sham operation group, which had a statistical significance ( P < 0.05 ), and the MTT values were all higher than that of the sham operation group, which had a statistical significance ( P < 0.05 ). The TTP values of rats in the experimental group were higher than those in the sham operation group at 6 h, 24 h, and 72 h after modeling ( P < 0.05 ), the experimental group was in the modeling. The levels of serum ET-1, IL-1, and IL-6 at 1 h, 6 h, 24 h, and 72 h were higher than those in the sham operation group, which had a statistical significance ( P < 0.05 ). New Zealand white rabbits can have brain perfusion volume disorder, inflammatory reaction, and cerebral vasospasm in the early stage after SAH, and brain injury can appear in the early stage.

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“…A CT combined with CTA and CTP was performed routinely in all comatose/sedated patients on day 3 and day 7 after the bleeding event. Additionally, CT, CTA, and CTP were done in cases of DIND or TCD-VSP, and in case of an increase in BFV-acceleration of >50 cm/s within 24 h. The CTP parameters were analyzed qualitatively and quantitatively using cutoff values (time to drain > 4.93 s, cerebral blood flow <53.93 ml/100 ml/min, mean transit time > 4.25, time to start > 9.28 s, cerebral blood volume <3.14 ml/100 ml), which were previously published elsewhere ( 16 ).…”

Section: Methodsmentioning

confidence: 99%

“…It is crucial that hemodynamically relevant CVS is being detected early and reliably to justify an interventional treatment. Computed tomography perfusion (CTP) has been increasingly used during the last years for the prediction of DCI and the detection of “tissue at risk” in patients with aSAH ( 16 ). However, due to the associated radiation exposure, CTP is not suitable for continuous monitoring of cerebral perfusion and is usually performed once DCI is being suspected with the aim to confirm the diagnosis and for the initiation of further treatment.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Endovascular Rescue Therapy on the Clinical and Radiological Outcome After Aneurysmal Subarachnoid Hemorrhage: A Safe and Effective Treatment Option for Hemodynamically Relevant Vasospasm?

et al. 2022

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ObjectiveCerebral vasospasm (CVS) represents one of the multiple contributors to delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Especially the management of CVS, refractory to medical treatment, is a challenging task during the acute phase after aSAH. Endovascular rescue therapies (ERT), such as medical and mechanical dilation, are possible treatment options on an individual basis. However, data about the influence on the patients' functional outcomes are limited. This study aims to assess the impact of ERT on the long-term functional outcome in aSAH-patients with refractory CVS.MethodsWe performed a retrospective analysis of aSAH patients treated between 2012 and 2018. CVS was considered refractory, if it persisted despite oral/intravenous nimodipine application and induced hypertension. The decision to perform ETR was made on an individual basis, according to the detection of “tissue at risk” on computed tomography perfusion (CTP) scans and CVS on computed tomography angiography (CTA) or digital subtraction angiography (DSA). The functional outcome was assessed according to the modified Rankin scale (mRS) 3 months after the ictus, whereas an mRS ≤ 2 was considered as a good outcome.ResultsA total of 268 patients were included. Out of these, 205 patients (76.5%) were treated without ERT (group 1) and 63 patients (23.5%) with ERT (group 2). In 20 patients (31.8%) balloon dilatation was performed, in 23 patients (36.5%) intra-arterial nimodipine injection alone, and in 20 patients (31.8%) both procedures were combined. Considering only the patient group with DCI, the patients who were treated with ERT had a significantly better outcome compared to the patients without ERT (Mann–Whitney test, p = 0.02).ConclusionEndovascular rescue therapies resulted in a significantly better functional outcome in patients with DCI compared to the patient group treated without ETR. CTP and CTA-based identification of “tissue at risk” might be a reliable tool for patient selection for performing ERT.

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Defining cutoff values for early prediction of delayed cerebral ischemia after subarachnoid hemorrhage by CT perfusion

Cited by 18 publications

References 31 publications

Prediction and Risk Assessment Models for Subarachnoid Hemorrhage: A Systematic Review on Case Studies

Prediction and Risk Assessment Models for Subarachnoid Hemorrhage: A Systematic Review on Case Studies

The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage

The Impact of Endovascular Rescue Therapy on the Clinical and Radiological Outcome After Aneurysmal Subarachnoid Hemorrhage: A Safe and Effective Treatment Option for Hemodynamically Relevant Vasospasm?

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