gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Article

Send article

Correlation of CT perfusion with CT angiography for the detection of hemodynamically relevant vasospasm after aneurysmal subarachnoid hemorrhage

Meeting Abstract

Search Medline for

  • Vesna Malinova - Neurochirurgische Klinik, Universitätsmedizin Göttingen
  • Karoline Dolatowski - Abteilung für Neuroradiologie, Universitätsmedizin Göttingen
  • Peter Schramm - Abteilung für Neuroradiologie, Universitätsmedizin Göttingen
  • Veit Rohde - Neurochirurgische Klinik, Universitätsmedizin Göttingen
  • Dorothee Mielke - Neurochirurgische Klinik, Universitätsmedizin Göttingen

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocDI.11.01

doi: 10.3205/14dgnc176, urn:nbn:de:0183-14dgnc1767

Published: May 13, 2014

© 2014 Malinova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: The detection of hemodynamically relevant vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) is essential before an invasive treatment can be initiated, in order to prevent cerebral infarction and permanent neurological deficits. The aim of this study was to evaluate the correlation of perfusion deficits detected by CT perfusion (CTP) with angiographic vasospasm identified by CT angiography (CTA) as a noninvasive diagnostic technique to detect cerebral vasospasm in patients with aSAH.

Method: In 43 consecutive patients with aSAH, whole brain volume CTP was performed for early (<DAY5) identification „tissue risk“. In 26 these has been conducted combination CTP, 13 patients had at least two further CTA scans during period (day5 to day 14). Qualitative quantitative measurements deficits, angiographic were explored. Furthermore, correlation between vessel territories with perfusion deficits identified CTP and the CT-angiographic location of vasospasm evaluated. Daily neurological assessment well transcranial Doppler sonography (TCD) bedside screening method performed in every patient, whereas TCD-vasospasm was defined as mean blood flow velocities >120 cm/s.

Results: We analyzed a total of 45 CTP and CTA data in 27 patients with aSAH. The mean age of the patients was 51.4 yrs (range 29–71). Seventeen patients were female, 10 male. Territorial perfusion deficits were seen on 23 CTPs in 12 patients. In 73% (17/23) of the CTP scans, a correlation of the vessel territory with perfusion deficits and the location of angiographic vasospasm was found. All 12 patients developed delayed ischemic neurological deficits (DIND), whereas only 6 of them had shown increased blood flow velocities measured by TCD at the same time. Five of the 12 patients with perfusion deficits received endovascular treatment by means of balloon angioplasty.

Conclusions: The combination of CTP and CTA shows a high correlation between the location of „tissue at risk“ identified as perfusion deficits, and the vessel territory with angiographic vasospasm. Hence, it seems to be a promising noninvasive guide of the decision making for invasive treatment in patients with aSAH.