title: Early CT perfusion changes and blood-brain barrier permeability after aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Early brain injury (EBI) can occur within 72 h of aneurysmal subarachnoid hemorrhage (aSAH). The objective of this study was to determine if there are differences in early CTP parameters (<72 h) with respect to delayed cerebral ischemia (DCI), cerebral infarction, and functional outcome.
  
  
  METHODS
  We performed a prospective cohort study of aSAH patients admitted to a single tertiary care center. MTT, CBF and blood-brain barrier permeability (PS) were quantified with CTP within 72 h of aneurysm rupture. Primary outcomes were functional outcome by the Modified Rankin Scale (mRS) at 3 months and cerebral infarction. Secondary outcome was the development of DCI. Differences between early CTP parameters were determined with respect to primary and secondary outcomes.
  
  
  RESULTS
  Fifty aSAH patients were included in the final analysis. MTT was significantly higher in patients who developed DCI (6.7 ± 1.2 vs 5.9 ± 1.0; p = 0.03) and cerebral infarction (7.0 ± 1.2 vs 5.9 ± 0.9; p = 0.007); however, no difference in MTT was found between patients with and without a poor outcome (mRS > 2). Early CBF and PS did not differ with respect to functional outcome, DCI, and cerebral infarction.
  
  
  CONCLUSIONS
  Elevated MTT within 72 h of aneurysm rupture is associated with DCI and cerebral infarction but not with long-term functional outcome. Blood-brain barrier permeability, as assessed by CT perfusion, was not associated with DCI or worse outcome in this cohort.
authors: Department of Medical Imaging, University of Toronto, Room 3-077CC, 30 Bond St, Toronto, ON, M5B 1W8, Canada, amanda.murphy@mail.utoronto.ca.
authors: Amanda
authors: A
authors: Murphy
authors: Airton Leonardo de Oliveira
authors: AL
authors: Manoel
authors: Kyle
authors: K
authors: Burgers
authors: Ekaterina
authors: E
authors: Kouzmina
authors: Ting
authors: T
authors: Lee
authors: R Loch
authors: RL
authors: Macdonald
authors: Aditya
authors: A
authors: Bharatha
mesh_terms: D001783:Blood Flow Velocity; D001812:Blood-Brain Barrier / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002199:Capillary Permeability; D002533:Cerebral Angiography / Q000379:methods*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*