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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Perfusion CT fails to predict vasospasms after subarachnoid hemorrhage but responds to intraarterial vasospasmolysis

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  • Athanasios K. Petridis - Heinrich Heine University Duesseldorf, Department of Neurosurgery, Duesseldorf, Deutschland
  • Caroline Dietrich - Duesseldorf, Deutschland
  • Jasper van Lieshout - Duesseldorf, Deutschland
  • Igor Fischer - Duesseldorf, Deutschland
  • Marcel Alexander Kamp - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Duesseldorf, Deutschland
  • Jan Frederick Cornelius - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf, Heinrich Heine Universität, Duesseldorf, Deutschland
  • Hans-Jakob Steiger - Universitätsklinikum Düsseldorf, Neurochirurgische Klinik, Düsseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 209

doi: 10.3205/17dgnc772, urn:nbn:de:0183-17dgnc7724

Published: June 9, 2017

© 2017 Petridis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: There is still controversial discussion of the value of perfusion computed tomography (CTP) in predicting vasospasms in patients with aneurysmal SAH (aSAH). The present study was conducted to evaluate changes of CTP values in patients with intraarterial spasmolytic therapy (angiographically) before and after the intervention.

Methods: Retrospective analysis of, CTP and angiographies of N=141 patients treated from 2013-2015. In N=59 patients intra-arterial spasmolysis had been performed and in these cases CTP data were compared before and after lysis.

Results: After i.a. spasmolysis in patients with vasospasms the MTT showed significant improvement indicating to a significant correlation of blood flow in angiography and CT-perfusion. Surprisingly, there was no correlation between the known thresholds of mean transit time (MTT) in CTP and vasospasm.

Conclusion: Even when CTP did not identify vasospasms by changes of the MTT in order to establish a definitive pathological cut off value the MTT after angiographically lysis of spastic vessels was significantly lower compared to the values before lysis. CTP can not identify vasospasm but correlates to a response of spasmolytic therapy.