Perfusion CT to evaluate the effect of transluminal angioplasty on cerebral perfusion in the treatment of vasospasm after subarachnoid hemorrhage.
BACKGROUND
Delayed ischemic neurologic deficits secondary to vasospasm are a major cause of morbidity and mortality after subarachnoid hemorrhage (SAH). Treatment of vasospasm after SAH is associated with complications, and reliable techniques for evaluating effects of treatment of vasospasm in such patients are warranted. We present the use of perfusion computed tomography (PTC) to evaluate the effect of transluminal percutaneous angioplasty in a with SAH and vasospasm-induced ischemia.


METHODS
Dynamic PCT with deconvolution produced maps of time-to-peak, mean transit time, regional cerebral blood flow, and regional cerebral blood volume, with a computerized automated map of the infarct and penumbra. CT scanners with quadruple detector array were used before and after angioplasty.


RESULTS
Before angioplasty and intraarterial papaverine, PCT showed normal to decreased cerebral blood flow and increased cerebral blood volume and mean transit time in the middle cerebral artery territory of the left hemisphere. After angioplasty and intraarterial papaverine, PCT showed normalization of perfusion parameters.


CONCLUSIONS
PCT can be a useful technique in monitoring angioplasty treatment effects in patients with vasospasm after SAH.
Majoie
Charles B L M
CB
Department of Radiology, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, the Netherlands.
van Boven
Leonard J
LJ
van de Beek
Diederik
D
Venema
Henk W
HW
van Rooij
Willem J
WJ
D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods*; D001037:Aphasia / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging* / Q000209:etiology