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Cerebral perfusion changes in acute subdural hematoma
INTRODUCTION: Acute subdural hematoma (aSDH) is one of the main causes of high mortality and morbidity in traumatic brain injury. Prognosis is poor due to the rapid volume shift and mass effect. Cerebral perfusion is likely affected in this condition. This study quantifies perfusion changes in aSDH...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Vienna
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10477107/ https://www.ncbi.nlm.nih.gov/pubmed/37460666 http://dx.doi.org/10.1007/s00701-023-05703-6 |
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author | Winkler, J. Piedade, G. S. Rubbert, C. Hofmann, B. B. Kamp, M. A. Slotty, P. J. |
author_facet | Winkler, J. Piedade, G. S. Rubbert, C. Hofmann, B. B. Kamp, M. A. Slotty, P. J. |
author_sort | Winkler, J. |
collection | PubMed |
description | INTRODUCTION: Acute subdural hematoma (aSDH) is one of the main causes of high mortality and morbidity in traumatic brain injury. Prognosis is poor due to the rapid volume shift and mass effect. Cerebral perfusion is likely affected in this condition. This study quantifies perfusion changes in aSDH using early ER polytrauma CT with perfusion imaging (CTP). METHODS: Data of 54 patients with traumatic aSDH were retrospectively collected. Glasgow Coma scale (GCS), perfusion parameters, therapeutic decisions and imaging data including hematoma thickness, midline shift, and hematoma localization were analyzed. The cortical perfusion parameters of each hemisphere, the area anterior to the hematoma (AAH), area below the hematoma (ABH), area posterior to the hematoma (PAH), and corresponding mirrored contralateral regions were determined. RESULTS: We found a significant difference in Tmax in affected and unaffected whole-hemisphere data (mean 4.0 s vs. 3.3 s, p < 0.05) and a significantly different mean for Tmax in ABH and for the corresponding mirrored area (mABH) (mean 3.8 s vs. 3.1 s, p < 0.05). No significant perfusion changes in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were found. CONCLUSION: There was a significant elevation of time to maximum (Tmax) values in the underlying cortical area of aSDH. Possible pathophysiological explanations, the influence on immediate surgical decision-making and further therapeutic consequences have to be evaluated. |
format | Online Article Text |
id | pubmed-10477107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Vienna |
record_format | MEDLINE/PubMed |
spelling | pubmed-104771072023-09-06 Cerebral perfusion changes in acute subdural hematoma Winkler, J. Piedade, G. S. Rubbert, C. Hofmann, B. B. Kamp, M. A. Slotty, P. J. Acta Neurochir (Wien) Original Article INTRODUCTION: Acute subdural hematoma (aSDH) is one of the main causes of high mortality and morbidity in traumatic brain injury. Prognosis is poor due to the rapid volume shift and mass effect. Cerebral perfusion is likely affected in this condition. This study quantifies perfusion changes in aSDH using early ER polytrauma CT with perfusion imaging (CTP). METHODS: Data of 54 patients with traumatic aSDH were retrospectively collected. Glasgow Coma scale (GCS), perfusion parameters, therapeutic decisions and imaging data including hematoma thickness, midline shift, and hematoma localization were analyzed. The cortical perfusion parameters of each hemisphere, the area anterior to the hematoma (AAH), area below the hematoma (ABH), area posterior to the hematoma (PAH), and corresponding mirrored contralateral regions were determined. RESULTS: We found a significant difference in Tmax in affected and unaffected whole-hemisphere data (mean 4.0 s vs. 3.3 s, p < 0.05) and a significantly different mean for Tmax in ABH and for the corresponding mirrored area (mABH) (mean 3.8 s vs. 3.1 s, p < 0.05). No significant perfusion changes in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were found. CONCLUSION: There was a significant elevation of time to maximum (Tmax) values in the underlying cortical area of aSDH. Possible pathophysiological explanations, the influence on immediate surgical decision-making and further therapeutic consequences have to be evaluated. Springer Vienna 2023-07-18 2023 /pmc/articles/PMC10477107/ /pubmed/37460666 http://dx.doi.org/10.1007/s00701-023-05703-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Winkler, J. Piedade, G. S. Rubbert, C. Hofmann, B. B. Kamp, M. A. Slotty, P. J. Cerebral perfusion changes in acute subdural hematoma |
title | Cerebral perfusion changes in acute subdural hematoma |
title_full | Cerebral perfusion changes in acute subdural hematoma |
title_fullStr | Cerebral perfusion changes in acute subdural hematoma |
title_full_unstemmed | Cerebral perfusion changes in acute subdural hematoma |
title_short | Cerebral perfusion changes in acute subdural hematoma |
title_sort | cerebral perfusion changes in acute subdural hematoma |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10477107/ https://www.ncbi.nlm.nih.gov/pubmed/37460666 http://dx.doi.org/10.1007/s00701-023-05703-6 |
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