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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Cerebral energy status and altered metabolism in early brain injury after aneurysmal SAH – first results of a prospective 31P-MRS study

Zerebraler Energiestatus und veränderter Metabolismus in der Akutphase nach aneurysmatischer SAB – erste Ergebnisse einer prospektiven Phosphorspektroskopie-Studie

Meeting Abstract

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  • presenting/speaker Alice Görke - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria
  • Wing Mann Ho - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria
  • Ruth Steiger - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria
  • Astrid Ellen Grams - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria
  • Elke Gizewski - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria
  • Berndhard Glodny - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria
  • Claudius Thomé - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria
  • presenting/speaker Ondra Petr - Medizinische Universität Innsbruck, Univ.-Klinik für Neurochirurgie, Innsbruck, Austria

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV223

doi: 10.3205/19dgnc240, urn:nbn:de:0183-19dgnc2401

Veröffentlicht: 8. Mai 2019

© 2019 Görke et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Acute changes of cerebral energy metabolism in early brain injury (EBI) after aneurysmal SAH play a crucial role for overall neurologic outcome. However, direct detection of these alterations is limited.

Phosphorous magnetic resonance spectroscopy (31P-MRS) is a molecular-based advanced neuroimaging technique allowing measurements of pathophysiological processes and tissue metabolism, and may provide objective assessment of primary versus secondary alterations. Pathophysiological changes of cerebral energy metabolism are detectable based on various phosphorous compound metabolites. The aim of this pilot study is to evaluate the feasibility and the diagnostic potential of ultra early 31P-MRS in aSAH.

Methods: Adult patients with aSAH, treated for ruptured aneurymss between June 2016 and July 2017, who were eligible for MRI, were prospectively included in the study. MRI scans plus 31P-MRS were performed within 72 hours after aSAH. 31P-MRS data from the structurally affected side / vascular territory (ACA, MCA, PCA, BA, VA, basal ganglia analyzed separately) were compared to data from normal appearing contralateral areas, and to data of healthy controls. Imaging was performed using a 3-Tesla MRI with a Dual Tuned Head Coil. 31P-MRS quantifies phosphorous compound metabolites and changes in ATP metabolism. The ratios of these metabolites are used for metabolism assessment. One-way analysis of variance (ANOVA) with post hoc procedure of Tukey-HSD was performed to assess pairwise differences.

Results: Fourteen aSAH patients (11 female and 3 male patients) met inclusion criteria and were analyzed. Statistical analysis revealed substantial acute general alterations of cerebral energy metabolism in early brain injury after aSAH (P<0.05).

Conclusion: 31P-MRS seems to be a promising tool for a comprehensive assessment of patients after aneurysmal SAH showing pertinent changes in energy metabolism with an obvious potential to optimize early guidance of clinical therapy.