Document Detail


Regional cerebral blood flow in peritumoral brain edema during dexamethasone treatment: a xenon-enhanced computed tomographic study.
MedLine Citation:
PMID:  9696075     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Regional cerebral flood flow (rCBF) in peritumoral brain edema is assumed to be decreased because of increased interstitial pressure. Impaired blood flow might lead to local hypoxia, altered metabolism, and disturbed ion homeostasis, thus causing neurological sequelae. Steroid treatment is thought to positively influence the sequelae of brain edema. We aimed to determine the rCBF in peritumoral edema in humans receiving dexamethasone treatment and the relationship of rCBF to global CBF. METHODS: We measured rCBF in 11 patients with untreated anaplastic gliomas or glioblastomas that were World Health Organization Grade III or IV restricted to one hemisphere with significant peritumoral edema who were receiving a standard dose of dexamethasone. rCBF was determined using stable xenon-enhanced computed tomography in a stereotactic frame. Edema was defined both by means of actual histology (stereotactic biopsies) and by imaging criteria. RESULTS: rCBF in peritumoral edema was decreased by 32% as compared with contralateral normal white matter. In each patient, this reduction was linearly related to blood flow in nonaffected white matter and cortex. The flow ratio in the different compartments was 1 (edema):1.5 (contralateral white matter):2.7 (contralateral cortex). Absolute perfusion values in contralateral cortex (means +/- standard deviations) (29.9+/-7.1 ml/100 g/min) and contralateral white matter (16.1+/-3.7 ml/100 g/min) were significantly decreased as well. CONCLUSION: Our study demonstrated that rCBF in peritumoral brain edema during steroid treatment is still decreased and is in a range in which it may cause neurological sequelae. Also, global CBF was decreased in all patients.
Authors:
P F Behrens; C B Ostertag; P C Warnke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  43     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-11-24     Completed Date:  1998-11-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  235-40; discussion 240-1     Citation Subset:  IM    
Affiliation:
Neurologische Universitätsklinik, Freiburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Inflammatory Agents / adverse effects,  therapeutic use*
Blood Flow Velocity / drug effects
Brain / blood supply*
Brain Edema / drug therapy*,  radiography
Cerebral Cortex / blood supply
Contrast Media*
Dexamethasone / adverse effects,  therapeutic use*
Dominance, Cerebral / drug effects
Female
Glioblastoma / drug therapy*,  radiography
Glioma / drug therapy*,  radiography
Humans
Intracranial Pressure / drug effects
Magnetic Resonance Imaging
Male
Middle Aged
Neurologic Examination / drug effects
Regional Blood Flow / drug effects
Supratentorial Neoplasms / drug therapy*,  radiography
Tomography, X-Ray Computed*
Xenon / diagnostic use*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Contrast Media; 50-02-2/Dexamethasone; 7440-63-3/Xenon

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


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