gms | German Medical Science

Objective: The grading of initial neurological impairment after aneurysmal subarachnoid hemorrhage (SAH) has shown to correlate significantly with patient's outcome. Immediate hypoperfusion is likely to play the major responsible role for the initial neurological status. The goal of the present study is to analyze the early perfusion in patients suffering from aneurysmal subarachnoid hemorrhage and the correlation with neurological outcome.

Methods: In the present pilot series 15 patients with SAH received an early CT based perfusion measurement that was performed within the first 12 hours after initial bleeding. In all patients the mean transit time (MTT), the time to peak (TTP), the cerebral blood flow (CBF) and the cerebral blood volume (CBV) were calculated and analyzed. The results were correlated with the initial clinical status according to WFNS and the Glasgow Outcome Scale (GOS) at time of discharge.

Results: The MTT proved to correlate significantly with the initial WFNS scale and the GOS at time of discharge. MTT of the right hemisphere in WFNS°I patients (n=5) was 3.3 s (±0.5), WFNS°II-III (n=3) 4.0 s (±0.2) and in WFNS°IV-V (n=7) 4.4 s (±0.6) whereas MTT on the left in WFNS°I patients was 3.2 s (± 0.5), in WFNS°II-III patients 4.1 s (±0.4) and in WFNS°IV-V patients 4.5 s (±0.6). Further parameters did not show significant correlation.

Conclusions: The results of the present pilot study indicates that MTT obtained from early CT-perfusion measurement correlates significantly with the initial neurological grading and the clinical outcome in patients suffering from aneurysmal subarachnoid hemorrhage. Therefore we start to analyze the predictive value of early perfusion-CT in a larger series.