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Prognostic Assessment of Aneurysmal Subarachnoid Patients with WFNS Grade V by CT Perfusion on Arrival
- Source :
- World neurosurgery. 92
- Publication Year :
- 2016
-
Abstract
- Background The prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH) depends on their condition on arrival at the hospital. However, a small number of patients recover from an initially poor condition. We investigated the correlation between quantitative measures of computed tomography (CT) perfusion (CTP) on arrival and the outcomes of patients with World Federation of Neurosurgical Society (WFNS) grade V aSAH. Methods We performed plain CT, CTP, and CT angiography (CTA) in all patients with aSAH on arrival. Aneurysms were surgically obliterated in patients with stable vital signs and the presence of a brain stem response. We measured the average mean transit time (aMTT) and compared it with the modified Rankin Scale (mRS) score at 1 month. Regions of interest were identified as 24 areas in the bilateral anterior, middle, and posterior cerebral artery territories and 2 areas in the basal ganglia. Results A total of 57 patients were treated between 2007 and 2014. None of the 21 patients with aMTT >6.385 seconds achieved a favorable outcome, whereas 8 of the 36 patients with aMTT P = 0.015). Furthermore, comparing the number of areas showing a mean transit time (MTT) >7.0 seconds among the aforementioned 8 areas and mRS, favorable outcomes were not seen in 24 patients with more than 2 such areas ( P = 0.009). Conclusion We cannot expect a favorable outcome for patients with WFNS grade V aSAH with aMTT >6.385 seconds or more than 2 of 8 areas with MTT >7.0 seconds.
- Subjects :
- Adult
Male
medicine.medical_specialty
Subarachnoid hemorrhage
Time Factors
Computed Tomography Angiography
Perfusion scanning
Posterior cerebral artery
Severity of Illness Index
Basal Ganglia
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Modified Rankin Scale
medicine.artery
medicine
Anterior cerebral artery
Humans
Computed tomography angiography
Aged
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
business.industry
Cerebral Arteries
Middle Aged
Subarachnoid Hemorrhage
medicine.disease
Perfusion
Cerebral blood flow
Angiography
Surgery
Female
Neurology (clinical)
Radiology
business
Tomography, X-Ray Computed
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18788769
- Volume :
- 92
- Database :
- OpenAIRE
- Journal :
- World neurosurgery
- Accession number :
- edsair.doi.dedup.....881a3fc6ecae96c4cd06071b4244f9fe