Document Detail


CT perfusion evidence of early global cerebral hypoperfusion after aneurysmal subarachnoid hemorrhage with cardiac arrest.
MedLine Citation:
PMID:  19960272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac arrest and aneurysmal subarachnoid hemorrhage both cause sudden, severe cerebral hypoperfusion at ictus. Animal studies indicate that the resultant microvascular dysfunction and cerebral perfusion abnormalities are important determinants of the associated cerebral injury in both conditions. Although this suggests that perfusion imaging might be a useful tool for prognostication in patients with these conditions, this hypothesis has not been thoroughly investigated in humans. METHODS: Case report. RESULTS: A 49-year-old man developed cardiac arrest upon rupture of an intracranial aneurysm. When he arrived at our institution 10 h later, he was comatose, had neurogenic hyperventilation, absent corneal reflexes, and continuous multifocal myoclonus. Despite normal intracranial pressure, normal cerebral perfusion pressure, normal flow in the proximal cerebral arteries on CT angiography, and a lack of diffuse cerebral edema, CT perfusion imaging performed 12 h after ictus showed severe, diffuse hypoperfusion. After the development of refractory intracranial hypertension, physiologic support was withdrawn and the patient died. CONCLUSIONS: Early global cerebral hypoperfusion can be demonstrated by CT perfusion imaging after cardiac arrest associated with high-grade aneurysmal subarachnoid hemorrhage and may be indicative of poor neurologic outcome. CT perfusion should be investigated as a prognostic tool in these conditions.
Authors:
Joseph D Burns; Jeffrey T Jacob; Patrick H Luetmer; Eelco F M Wijdicks
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurocritical care     Volume:  12     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-4     Citation Subset:  IM    
Affiliation:
Department of Neurology, Boston University School of Medicine, Collamore Building, C-3, 72 East Concord St, Boston, MA 02118, USA. joseph.burns@bmc.org
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MeSH Terms
Descriptor/Qualifier:
Brain* / blood supply,  physiopathology,  radiography
Cerebrovascular Circulation / physiology
Heart Arrest / complications*
Humans
Male
Middle Aged
Subarachnoid Hemorrhage / complications*,  diagnosis*
Tomography, X-Ray Computed*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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