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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Pathophysiological changes in cerbral energy metabolism and vasospasm after aneurysmatic subarachnoid haemorrhage – a prospective 31-P-MR-spectroscopy study in the subacute state

Pathophysiologische Veränderungen im Hirnstoffwechsel und Vasospasmus nach aneurysmatischer Subarachnoidalblutung – eine prospektive 31-P-MR-Spektroskopie-Studie in der subakuten Phase

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  • presenting/speaker Stephanie Alice Treichl - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich
  • Wing Mann Ho - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich
  • Johanna Schönherr - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich
  • Claudius Thomé - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich
  • Ondra Petr - Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Österreich

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP177

doi: 10.3205/22dgnc493, urn:nbn:de:0183-22dgnc4930

Published: May 25, 2022

© 2022 Treichl 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

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Objective: Changes of cerebral energy metabolism after aneurysmal subarachnoid hemorrhage (aSAH) and development of DCI might play a crucial role for overall neurological outcome. Phosphorous magnetic resonance spectroscopy (31P-MRS) is a molecular-based advanced neuroimaging technique allowing measurements of pathophysiological processes and tissue metabolism based on various phosphorous compound metabolites. This method may provide objective assessment of secondary changes. The aim of this pilot study was to evaluate changes in the subacute state after aSAH and to analyze to effect of vasospasm on cerebral metabolism.

Methods: We included patients with aSAH in this prospective study. 31-P-MR-spectrocopy was performed between 6 and 14 days after SAH. The voxels were selected anterior, media, posterior, and basal ganglia. Relative values of phospodiesters (PDE), phospomonoesters (PME), inorganic phosphate (Pi), phosphocreatine (PCr), total adenosine triphosphate (α- / β- / γ- ATP) and the ratios PCr/ATP, PCr/Pi, Pi/ATP and PME/PDE were obtained. Data were also analysed respecting clinical data and vasospasm. Our data were compared to spectroscopy data from an age- and sexmatched control group.

Results: 31P-MRS was done in 21 patients aged 29 to 67 and the data was compared to 21 healthy controls. We found significant changes of energy metabolism and membrane turnover compared to the acute state and healthy control group. ATP synthesis and degradation were significant impaired as well as energy demand of the brain tissue. The effect was much more pronounced in patients with vasospasm.

Conclusion: 31P-MRS is a non-invasive imaging tool for the assessment of tissue metabolism and showed significant changes of energy metabolism and membrane turnover in the subacute state after aSAH. Vasospasm seems to have an impact on energy metabolism.