| Cerebral vascular autoregulation assessed by perfusion-CT in severe head trauma patients. | |
| | |
MedLine Citation:
|
PMID: 16528203 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: To use perfusion-CT technique in order to characterize cerebral vascular autoregulation in a population of severe head trauma patients with features of cerebral edema either on the admission or on the follow-up conventional noncontrast cerebral CT. MATERIAL AND METHODS: A total of 80 perfusion-CT examinations were obtained in 42 severe head trauma patients with features of cerebral edema on conventional noncontrast cerebral CT, either on admission or during follow-up. Perfusion-CT results, i.e. the regional cerebral blood volume (rCBV) and flow (rCBF), were correlated with the mean arterial pressure (MAP) measured during each perfusion-CT examination. Ratios were defined to integrate the concept of cerebral vascular autoregulation, and cluster analysis performed, which allowed identification of different subgroups of patients. MAP values and perfusion-CT results in these groups were compared using Kruskal-Wallis and Wilcoxon (Mann-Whitney) tests. Moreover, the functional outcome of the 42 patients was evaluated 3 months after trauma on the basis of the Glasgow Outcome Scale (GOS) score and similarly compared between groups. RESULTS: Three main groups of patients were identified: 1) 22 perfusion-CT examinations were collected in 13 patients, characterized by high rCBV and rCBF values and by significant dependence of perfusion-CT rCBV and rCBF results on MAP values (p<0.001), 2) 23 perfusion-CT examinations collected in 19 patients showing perfusion-CT results similar to control trauma subjects, and 3) 33 perfusion-CT collected in 16 patients, with low rCBV and rCBF values and near-independence of perfusion-CT results with respect to MAP values. The first group was interpreted as showing impaired cerebral vascular autoregulation, which was preserved in the third group. The second group was associated with the best functional outcome; it was linked to the first group, because eight patients went from one group to the other from admission to follow-up. CONCLUSION: Perfusion-CT in severe head trauma patients was able to provide direct and quantitative assessment of cerebral vascular autoregulation with a single measurement. It could hence be used as a guide for brain edema therapy, as well as to monitor the treatment efficiency. |
| | |
Authors:
|
M Wintermark; R Chiolero; G Van Melle; J P Revelly; F Porchet; L Regli; P Maeder; R Meuli; P Schnyder |
Related Documents
:
|
21042503 - Unique features of polycythemia observed on plain non contrast ct scan of head. 7644693 - Progress in the ct evaluation of the cerebral atrophy in acute poisoning with carbon mo... 20694103 - Diagnostic accuracy of surface coil magnetic resonance imaging at 1.5 t for local stagi... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of neuroradiology. Journal de neuroradiologie Volume: 33 ISSN: 0150-9861 ISO Abbreviation: J Neuroradiol Publication Date: 2006 Feb |
Date Detail:
|
Created Date: 2006-03-10 Completed Date: 2006-05-18 Revised Date: 2008-02-20 |
Medline Journal Info:
|
Nlm Unique ID: 7705086 Medline TA: J Neuroradiol Country: France |
Other Details:
|
Languages: eng Pagination: 27-37 Citation Subset: IM |
Affiliation:
|
Department of Radiology, Neuroradiology Section, University of California, 505 Parnassus Avenue, Box 0628, San Francisco, CA 94143-0628, USA. max.wintermarkadiology.ucsf.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Blood Pressure / physiology Brain Edema / etiology, physiopathology, radiography Brain Injuries / complications, physiopathology*, radiography* Cerebrovascular Circulation / physiology* Female Follow-Up Studies Homeostasis / physiology* Humans Male Middle Aged Reproducibility of Results Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: 116 years (1889-2005) of neurosurgical practice and education at Gulhane Military Medical Academy.
Next Document: Imaging of acute cerebellitis in children. Report of 4 cases