title: Quantification of structural cerebral abnormalities on MRI 18 months after aneurysmal subarachnoid hemorrhage in patients who received endovascular treatment.
abstract: BACKGROUND
  Volume measurements performed on brain MRI after aneurysmal subarachnoid hemorrhage (aSAH) may provide insight into the structural abnormalities that underlie the commonly occurring and persistent long-term functional deficits after aSAH. We examined the pattern of long-term cerebral structural changes on MRI in relation to known risk factors for poor functional outcome.
  
  
  METHODS
  We studied MRI scans from 38 patients who received endovascular treatment and were not dependent for activities of daily life at 18 months after aSAH. Risk factors for poor functional outcome (clinical condition, Hijdra score, and bicaudate index on admission; occurrence of hydrocephalus or delayed cerebral infarction during hospitalization) were related to supratentorial cerebral parenchymal and lateral ventricular volumes on MRI with linear regression analyses adjusted for age, sex, and intracranial volume.
  
  
  RESULTS
  Clinical condition, Hijdra score, and bicaudate index on admission were not related to cerebral parenchymal volume at 18 months. A higher bicaudate index on admission was related to lateral ventricular enlargement at 18 months after aSAH (Beta; 95%CI: 0.51; 0.14↔0.88). Delayed cerebral infarction was related to smaller cerebral parenchymal volumes (-0.14; -0.25↔-0.04) and to lateral ventricular enlargement (0.49; 0.16↔0.83) at 18 months.
  
  
  CONCLUSIONS
  Volume measurements of the brain are able to quantify patterns of long-term cerebral damage in relation to different risk factors after aSAH. Application of volumetric techniques may provide more insight into the heterogeneous underlying pathophysiological processes. After confirmation of these results in larger studies, volumetric measures might even be used as outcome measures in future treatment studies.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands, j.debresser@umcutrecht.nl.
authors.forename: Jeroen
authors.initials: J
authors.lastname: de Bresser
authors.forename: Joanna D
authors.initials: JD
authors.lastname: Schaafsma
authors.forename: Merel J A
authors.initials: MJ
authors.lastname: Luitse
authors.forename: Max A
authors.initials: MA
authors.lastname: Viergever
authors.forename: Gabriel J E
authors.initials: GJ
authors.lastname: Rinkel
authors.forename: Geert Jan
authors.initials: GJ
authors.lastname: Biessels
mesh_terms: D000465:Algorithms; D001921:Brain / Q000473:pathology*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome