Role of Computed Tomography Perfusion in Detection of Patients at Risk for Delayed Cerebral Ischemia After Subarachnoid Hemorrhage
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 64
- 试验地点
- 1
- 主要终点
- Mean transit time (MTT) on Admission
研究概览
简要总结
Prospective evaluation of patients with subarachnoid hemorrhage (SAH) will be done by computed tomography angiography (CTA) and perfusion imaging (CTP) for any correlation between degree of vasospasm and perfusion deficit as well as evaluating the ability of CTP to predict delayed cerebral ischemia.
详细描述
Cerebral vasospasm is a serious complication of subarachnoid haemorrhage . In the first 2 weeks of SAH, angiographic vasospasm is seen up to 40-70% of patients and causes ischemic deficits in 15-36% of patients.
The best clinical indicator of significantly reduced brain perfusion (cerebral blood flow (CBF)<20 ml per 100 g/min) is the presence of new neurologic deficits. However, clinical symptoms may be vague and mimic other conditions in patients with SAH.
CT Perfusion can be used in the evaluation of patients with possible vasospasm after subarachnoid hemorrhage (SAH). It can thus be used to assess cerebral ischemia and infarction as a result of vasospasm after SAH.
The presence of cerebral vasospasm identified with transcranial Doppler, digital subtraction angiography, or CT angiography (CTA) is frequently used to confirm DCI. Presence of vasospasm, however, does not prove the presence of ischemia and absence of vasospasm does not rule out. Better diagnostic tests in the acute stage of deterioration, possibly caused by DCI, are therefore needed. In patients with SAH, CTP has recently been shown to be promising for detection of early ischemia.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients presented with subarachnoid haemorrhage
排除标准
- •Patients with abnormal renal functions with creatinine ≥ 2 mg/dl/
- •Patients with hypersensitivity to contrast media.
- •Contraindication to radiation as pregnancy.
结局指标
主要结局
Mean transit time (MTT) on Admission
时间窗: 3 days from the attack
Mean transit time (MTT) on Admission in units of seconds.
Cerebral blood flow (CBF) on Admission
时间窗: 3 days from the attack
Cerebral blood flow (CBF) on Admission in units of ml/100 gram brain tissue/ minute. The measurements will be compared with the outcome of the patient (namely monitoring delayed cerebral ischemia in SAH patients) to test if early CT perfusion could predict the poor outcome in SAH patients.
Cerebral blood volume (CBV) on Admission
时间窗: 3 days from the attack
Cerebral blood volume (CBF) on Admission in units of ml/100 gram brain tissue.
次要结局
- Correlation of vasospasm to perfusion abnormality using Comparing between CT angiography and CT perfusion in patients with subarachnoid hemorrhage(4-14 days from the attack)
- Hunt and Hess scale(3 days from the attack)
- Fisher scale(3 days from the attack)
研究者
Mohamed Abdel-Tawab Mohamed
Assistant Lecturer
Assiut University