Early diagnosis of cerebral vasospasm associated with cerebral ischemia following subarachnoid hemorrhage: Evaluation of computed tomography perfusion and transcranial doppler as accurate methods

Tsolaki,Vasiliki; Aravantinou-Fatorou,Aikaterini; Georgakopoulou,Vasiliki Epameinondas; Spandidos,Demetrios A.; Papalexis,Petros; Mathioudakis,Nikolaos; Tarantinos,Kyriakos; Trakas,Nikolaos; Sklapani,Pagona; Fotakopoulos,George

doi:10.3892/mi.2022.59

Early diagnosis of cerebral vasospasm associated with cerebral ischemia following subarachnoid hemorrhage: Evaluation of computed tomography perfusion and transcranial doppler as accurate methods

Authors:
- Vasiliki Tsolaki
- Aikaterini Aravantinou-Fatorou
- Vasiliki Epameinondas Georgakopoulou
- Demetrios A. Spandidos
- Petros Papalexis
- Nikolaos Mathioudakis
- Kyriakos Tarantinos
- Nikolaos Trakas
- Pagona Sklapani
- George Fotakopoulos
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Affiliations: Department of Pulmonary and Critical Care Medicine, General University Hospital of Larisa, 41221 Larisa, Greece, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Department of Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece, Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Renal Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece, First Department of Pulmonology, Sismanogleio Hospital, 15126 Athens, Greece, Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece, Department of Cytology, Mitera Hospital, 15123 Athens, Greece, Department of Neurosurgery, General University Hospital of Larisa, 41221 Larisa, Greece
Published online on: November 2, 2022 https://doi.org/10.3892/mi.2022.59
Article Number: 34
Copyright: © Tsolaki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Cerebral vasospasm (CV) constitutes a major post‑operative complication and source of morbidity in cases of subarachnoid hemorrhage (SAH). The early detection of CV in SAH may be difficult both clinically and radiographically. The present pilot study thus aimed to evaluate the practicability of the technique in a tertiary healthcare setting and to assess the diagnostic effectiveness of various diagnostic computed tomography (CT) perfusion (CTP) aspects in predicting the clinical outcome of patients with SAH (traumatic and aneurysmal). A retrospective study including 34 patients in a tertiary care hospital was thus conducted. The results revealed that of the 34 patients, 18 (52.9%) were males, and the mean age was 54.4±18.5 years (16‑85 years old; range, 69 years). In total, 15 (44.1%) patients had traumatic SAH following traumatic brain injury (TBI), 11 (33.3%) had aneurysmal SAH, and 8 patients (23.6%) presented with TBI without SAH as controls. CTP was performed on the third to the sixth day, and 15‑20 min prior to CPT, a transcranial Doppler ultrasound was performed. Clinical outcomes were documented at 30 days using a CT scan and a complete neurological evaluation, including Glasgow Coma Scale assessment. The results of a multivariate analysis revealed that cerebral blood flow (CBF) was an independent factor for detecting an ischemic event in 1 month (P=0.003). On the whole, the present study demonstrates that CTP, and consequently CBF, is a considerable index that may identify the onset of cerebral ischemia in patients with SAH.

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