Role of CT Perfusion in Predicting Poor Outcome After Subarachnoid Hemorrhage

Assiut University

Status: Completed

Conditions: Subarachnoid Hemorrhage; Delayed Cerebral Ischemia; Cerebral Vasospasm

Study type: Observational

Funder types: Other

Identifiers

NCT03214705

CTP predicts DCI

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 64 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients presented with subarachnoid haemorrhage

Exclusion criteria

• Patients with abnormal renal functions with creatinine ≥ 2 mg/dl/
• Patients with hypersensitivity to contrast media.
• Contraindication to radiation as pregnancy.

Trial design

64 participants in 2 patient groups

Patients with poor outcome

Description:

Follow up of patients is done for 21 days by combined clinical and radiological examination. Poor clinical outcome is associated with vasospasm leading to permanent neurological deficit, stroke or death.

Patients without poor outcome

Description:

Patients who do not develop delayed cerebral ischemia or stroke, confirmed by combined clinical and radiological examination.