The extent of the perihemorrhagic perfusion zone correlates with hematoma volume in patients with lobar intracerebral hemorrhage.
BACKGROUND
Existing data on perfusion imaging assumes the perihemorrhagic zone (PHZ) in patients with intracerebral hemorrhage (ICH) to be size steady. This study investigates the size of the perihemorrhagic zone (PHZ) in patients with lobar ICH in relation to hematoma volume during the course of treatment using perfusion CT (PCT).


METHODS
The present analysis is based on a previously reported cohort of 20 patients undergoing surgical evacuation for lobar SICH, with pre- and early postoperative PCT scanning. Time to peak of the residue function (T max) was measured based on the 360° cortical banding method and singular value decomposition. The size of PHZ was determined before and after treatment and correlated with hematoma volume.


RESULTS
Preoperative mean hematoma volume constituted 63.0 ml (interquartile ranges (IQR) 39.7-99.4 ml), which correlated significantly (r=0.563, p=0.010) with mean PHZ size (5.67 cm, IQR 5.44-8.17 cm). Following a surgical hematoma evacuation, mean hematoma volume was reduced to 2.5 ml IQR 0.0-9.5 ml, which also resulted in a significant reduction of PHZ size to 0.45 cm(IQR 0.0-1.36 cm; p<0.001). There was no association between postoperative hematoma volume and size of the PHZ.


CONCLUSIONS
Our findings illustrate that the extent of the PHZ cannot be generally assumed to be constant in size and that this differs significantly following hematoma reduction in patients with space occupying lobar SICH.
Department of Neurosurgery, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany, beseoglu@med.uni-duesseldorf.de.
Kerim
K
Beseoglu
Nima
N
Etminan
Bernd
B
Turowski
Hans-Jakob
HJ
Steiger
Daniel
D
Hänggi
D000368:Aged; D002533:Cerebral Angiography / Q000379:methods*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*