title: Perfusion CT in patients with spontaneous lobar intracerebral hemorrhage: effect of surgery on perihemorrhagic perfusion.
abstract: OBJECTIVE
  The aim of the present study was to investigate cerebral hemodynamics in patients requiring surgical treatment for lobar intracerebral hemorrhage.
  
  
  METHODS
  Twenty patients who underwent surgery to remove a lobar spontaneous intracerebral hemorrhage were scanned before and after surgery using perfusion CT mapping. Mean transit time, time to peak of the residue function, cerebral blood volume, and cerebral blood flow were measured in 4 defined regions of interest.
  
  
  RESULTS
  Preoperatively, time to peak of the residue function, cerebral blood volume, and cerebral blood flow were significantly impaired in the perihemorrhagic zone as compared with the ipsilateral and contralateral hemisphere. Perihematomal perfusion improved significantly after clot evacuation and there was no difference in time to peak of the residue function, cerebral blood flow, and cerebral blood volume values between the perihemorrhagic zone and ipsilateral as well as contralateral hemisphere after surgical treatment.
  
  
  CONCLUSIONS
  Our findings illustrate distinct perihemorrhagic perfusion impairments in a selected patient population with lobar intracerebral hemorrhage as evident by impaired time to peak of the residue function, cerebral blood flow, and cerebral blood volume and their improvement after early surgical treatment. Whether these early improvements in hemodynamic measurements may influence secondary neuronal injury and ultimately clinical outcome, as opposed to the natural course of spontaneous intracerebral hemorrhage remains unclear.
authors.affiliation: Department of Neurosurgery, University of Düsseldorf, Medical Faculty, Düsseldorf, Germany. etminan@uni-duesseldorf.de
authors.forename: Nima
authors.initials: N
authors.lastname: Etminan
authors.forename: Kerim
authors.initials: K
authors.lastname: Beseoglu
authors.forename: Bernd
authors.initials: B
authors.lastname: Turowski
authors.forename: Hans-Jakob
authors.initials: HJ
authors.lastname: Steiger
authors.forename: Daniel
authors.initials: D
authors.lastname: Hänggi
mesh_terms: D000368:Aged; D001810:Blood Volume / Q000502:physiology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures