Ischemic Brain Tissue Water Content: CT Monitoring during Middle Cerebral Artery Occlusion and Reperfusion in Rats¹

Abstract

CT is able to help monitor ischemic edema after MCA occlusion and reperfusion. Ischemic brain edema was not consistently reversible with reperfusion, even after 1 hour of occlusion, and further increased with reperfusion induced at 2 hours or later.

Use of Noncontrast Computed Tomography and Computed Tomographic Perfusion in Predicting Intracerebral Hemorrhage After Intravenous Alteplase Therapy

“…15 NCCT hypoattenuation degree is therefore a better marker of ischemia severity and time than hypoattenuation extent. [15][16][17] NCCT attenuation drops over time, whereas the infarct grows in size; this explains the modest correlation we see between NCCT hypoattenuation grade and ASPECTS at baseline. Our results support this premise and suggest that the contralateral white matter is a practical reference for physicians to assess degree of hypoattenuation and risk of PH with intravenous alteplase treatment.…”

Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008

“…CT is highly specific for the early identification of ischaemic brain damage [132, 140, 141]. The presence of early signs of ischaemia on CT should not exclude patients from thrombolysis within the first 3 h, though patients with a hypoattenuating ischaemic lesion which exceeds one third of the middle cerebral artery (MCA) territory may benefit less from thrombolysis [126, 134, 135, 142, 143].…”

Quantitative analysis of computed tomography images and early detection of cerebral edema for pediatric traumatic brain injury patients: retrospective study

“…The CES from deceased patients was defined as mortalityrelated CES (mCES). Additionally, it is well known that the brain water content varies with age [29,30]. The difference caused by age is clearly recognizable after the first two years of life [31,32].…”

“…According to an earlier study, a white matter density decrease of more than 5 HU is associated with symptoms of cerebral edema [68]. However, such a subtle decrease is nearly impossible to perceive with the human eye [29]. Higher HU 24 17 in the initial CT images from delayed cerebral edema subjects may reflect the early, elusive signs of vasogenic insult from TBI.…”