Early CT perfusion measurement after aneurysmal subarachnoid hemorrhage: a screening method to predict outcome?
OBJECTIVE
The goal of the present study is to analyze the predictive impact of early CT-based perfusion measurement (CTP) on clinical outcome in patients suffering from aneurysmal SAH.


METHODS
Fifteen patients with aneurysmal SAH received an early CTP measurement that was performed within the first 6 h after initial bleeding. According to a specific CTP protocol, mean transit time (MTT) and time to peak (TTP) were calculated bihemispherically and correlated with the clinical initial status according to the WFNS grade as well as with the Glasgow Outcome Scale (GOS) at the time of discharge.


RESULTS
The MTT and TTP correlated highly significantly with the initial WFNS grade and the GOS at the time of discharge. Mean bihemispheric MTT was 3.4 s (2.8-4.1 s, SD: 0.5 s) for initially good-grade patients (WFNS° I-III) and 4.5 s (31.2-49.8 s) for poor-grade patients (WFNS° IV-V). ICP monitored in nine patients via EVD was documented within normal intracranial pressure as defined below 18 mmHg.


CONCLUSIONS
The determination of MTT and TTP using early CTP measurements in patients suffering from aneurysmal SAH demonstrated a significant correlation with the initial neurological status and the early clinical outcome.
Department of Neurosurgery, Heinrich-Heine-University, Düsseldorf, Germany. marcelalexander.kamp@uni-duesseldorf.de.
Marcel A
MA
Kamp
Hi-Jae
HJ
Heiroth
Kerim
K
Beseoglu
Bernd
B
Turowski
Hans-Jakob
HJ
Steiger
Daniel
D
Hänggi
D000328:Adult; D000368:Aged; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010477:Perfusion; D011237:Predictive Value of Tests; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome