Study of perfusion in and around cerebral contusions by means of computed tomography.
BACKGROUND
Several authors have found low absolute values of cerebral blood flow (CBF) in both contusion core and pericontusional parenchyma ofhead-injured patients by means of Xenon Computed Tomography (CT). Perfusion CT has become available as a new and validated tool for studying CBF in patients. The aim of the present study was to assess the relation between volume expansion of contusions and pericontusional CBF measured by perfusion CT.


METHODS
Eight head-injured patients with a contusion on the admission CT head scan underwent a perfusion CT scan within 48 hours post trauma. The patients received standard head injury management. The eventual maximum contusion volume was assessed on the follow up plain CT scans.


RESULTS
Expansion of the contusion was observed in 6 patients. Reduced CBF was found in all contusions with absolute CBF values below 10 ml/100 g/min in the CT hyperdense/mixed density areas and below 20 ml/100 g/min in the surrounding hypodense areas. Penumbra areas, when defined by a mean transit time > 150% and cerebral blood volume > 2 ml/100 g, were limited to thin concentric rims surrounding the ischemic cores. We could not find a pattern of CBF that predicted contusion expansion.


CONCLUSIONS
Based on the present preliminary data there is no indication that contusion expansion can be predicted on the basis of pericontusional CBF data.
Depreitere
Bart
B
Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. bart.depreitere@uzleuven.be
Aviv
Richard
R
Symons
Sean
S
Schwartz
Michael
M
Coudyzer
Walter
W
Wilms
Guy
G
Marchal
Guy
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology; D006259:Craniocerebral Trauma / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*