gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Radiation-induced temporary hair loss after repeated Perfusion CT (PCT) during the treatment in one patient with PICA-Aneurysm

Strahlenbedingte Alopezie nach Diagnostik mit Perfusions-CT bei einer Patientin mit PICA-Aneurysma

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  • corresponding author Z. Mihajlovic - Department of Neurosurgery, University Medical Center of Schleswig Holstein, Campus Kiel
  • T. Straube - Department of Neuroradiology, University Medical Center of Schleswig Holstein, Campus Kiel
  • M.O. Pinsker - Department of Neurosurgery, University Medical Center of Schleswig Holstein, Campus Kiel
  • A. Nabavi - Department of Neurosurgery, University Medical Center of Schleswig Holstein, Campus Kiel
  • R. Buhl - Department of Neurosurgery, University Medical Center of Schleswig Holstein, Campus Kiel
  • O. Jansen - Department of Neuroradiology, University Medical Center of Schleswig Holstein, Campus Kiel
  • H.M. Mehdorn - Department of Neurosurgery, University Medical Center of Schleswig Holstein, Campus Kiel

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 10.164

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc381.shtml

Published: May 8, 2006

© 2006 Mihajlovic et al.
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Outline

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Objective: As dynamic contrast-enhanced studies become increasingly advanced, it is possible to obtain detailed morphological information as well as functional imaging data in the therapy of SAH. However these methods must be scrutinized in regards to possible side-effects and complications. In PCT the radiation dose increases with the ability to obtain more detailed information about the regional blood flow and perfusion of the brain in addition to DSA, TCD, monitoring of the tissue oxygenation (Licox) and ICP.

Methods: Perfusion CT (PCT) uses the temporal changes in cerebral blood attenuation during a rapid series of images acquired without table movement following an intravenous bolus of contrast medium to generate images in mean transit time (MTT), cerebral blood volume (CBV) and perfusion. The authors present a 63-year-old patient with SAH and left sided PICA Aneurysm who received a series of examinations after admission: twelve cCT Scans, three PCT (perfusion-CT) and four Angiographies (DSA). After successful coiling of the aneurysm, the patient developed vasopasm. PCT was used to detect the reduced blood flow. In order to prevent cerebral Infarction triple-H-therapy was performed under monitoring of ICP (Camino) and tissue oxygenation (Licox). Local vasopasm was treated two times by vasodilatation. Temporary bandage-shaped hair loss, which lasted for 3 Month, was seen on day 32 after the first perfusion study of the head.

Results: This case report suggests the possibility that radiation exposure from angiography performed in serial examinations, combined with the perfusion studies of the head with PCT and CCT, played an important role in this temporary, bandage-shaped hair loss.

Conclusions: Perfusion CT yields valuable hemodynamic information in the therapy of SAH. Nevertheless the side-effect of radiation induced alopezia has to be considered when the indication is discussed.