Role of diffusion-weighted MRG in predicting outcome in subarachnoid hemorrhage due to anterior communicating artery aneurysms.
OBJECTIVE
Efficacy of DWI in detecting ischemic injury following anterior communicating artery aneurysmal SAH is studied


METHODS
In this prospective study ,16 patients within 5 days of their ictus were included. Preoperative CT scan excluded an intracerebral infarct; an angiogram determined the extent of vasospasm; MR studies were done to detect cerebral ischemia and the diffusion coefficient (ADC) was calculated. Patients underwent surgery (n=12) or endovascular coiling (n=4). Postintervention CT scan within 24 hours and on day 5 determined radiological outcome as good or poor depending on the absence or presence of infarction. Clinical outcome at follow up (2-6 months) was regarded as good or poor when the patient was independent or dependent regarding daily activities, respectively,.


RESULTS
Restricted diffusion occurred in 8 (80%) of poor and in 1 (16.6%) of good grade patients (p < 0.05). In patients with good radiological outcome (n=8), DWI restriction occurred in 2 (25%) patients. In patients with poor radiological outcome(n=8), DWI restriction occurred in 7 (87.5%) patients . At 2-6 month follow-up, 7 (77.8%) of 9 patients with restricted diffusion and 2 of 7 patients with no DWI abnormality showed a poor clinical outcome


CONCLUSIONS
Clinical and radiological outcome at follow-up is related to the preoperative DWI.
Wani
Abrar Ahad
AA
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Neurosurgery, UP, India. abrarwani@rediffmail.com
Phadke
Rv
R
Behari
Sanjay
S
Sahu
Rn
R
Jaiswal
Awdesh
A
Jain
Vk
V
D000208:Acute Disease; D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000473:pathology