Background Several authors have found low absolute values of cerebral blood flow (CBF) in both contusion core and pericontusional parenchyma of head-injured patients by means of Xenon Computed Tomography (CT). Perfusion CT has become available as a new and validated tool for studying CBF in patients. The aim of the present study was to assess the relation between volume expansion of contusions and pericontusional CBF measured by perfusion CT.
Methods Eight head-injured patients with a contusion on the admission CT head scan underwent a perfusion CT scan within 48 hours post trauma. The patients received standard head injury management. The eventual maximum contusion volume was assessed on the follow up plain CT scans.
Findings Expansion of the contusion was observed in 6 patients. Reduced CBF was found in all contusions with absolute CBF values below 10 ml/100 g/min in the CT hyperdense/mixed density areas and below 20 ml/100 g/min in the surrounding hypodense areas. Penumbra areas, when defined by a mean transit time > 150% and cerebral blood volume > 2 ml/100 g, were limited to thin concentric rims surrounding the ischemic cores. We could not find a pattern of CBF that predicted contusion expansion.
Conclusions Based on the present preliminary data there is no indication that contusion expansion can be predicted on the basis of pericontusional CBF data.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bullock R, Golek J, Blake G (1989) Traumatic intracerebral hematoma—which patients should undergo surgical evacuation? CT scan features and ICP monitoring as a basis for decision making. Surg Neurol 32:181–187
Bullock MR, Chesnut R, Ghajar J et al (2006) Surgical management of traumatic parenchymal lesions. Neurosurg 58(Suppl 3):25–52
Busse R, Stoltenburg-Didinger G, von Eltz S et al (2002) Micro-circulatory disturbances after experimental traumatic brain injury—an immunohistochemical and ultrastructural study. Presented at the 7th Annual Conference of the Euroacademia Multidisciplinaria Neurotraumatologica, Newcastle (UK), June 26–29
Gallbraith S, Teasdale G (1981) Predicting the need for operation in the patient with an occult traumatic intracranial hematoma. J Neurosurg 55:75–81
Holmin S, Höjeberg B (2004) In situ detection of intracerebral cytokine expression after human brain contusion. Neurosci letters 369:108–114
McLaughlin MR, Marion DW (1996) Cerebral blood flow and vasoresponsivity within and around cerebral contusions. J Neuro-surg 85:871–876
Oertel M, Kelly DF, McArthur D et al (2002) Progressive hemorrhage after head trauma: predictors and consequences of evolving injury. J Neurosurg 96:109–116
Schröder ML, Muizelaar JP, Bullock MR et al (1995) Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies. J Neurosurg 82:966–971
Stoffel M, Eriskat J, Plesnila M et al (1997) The penumbra zone of a traumatic cortical lesion: a microdialysis study of excitatory amino acid release. Acta Neurochir (Wien) 70(Suppl):91–93
Tanaka H, Katayama Y, Kawamata T et al (1994) Excitatory amino acid release from contused brain tissue into surrounding brain areas. Acta Neurochir (Wien) 60(Suppl):524–527
von Oettingen G, Bergholt B, Gyldensted C et al (2002) Blood flow and ischemia within traumatic cerebral contusions. Neuro-surgery 50:781–790
Wintermark M, Thiran JP, Maeder P et al (2001) Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study. AJNR 22:905–914
Wintermark M, Flanders AE, Velthuis B et al (2006) Perfusion-CT assessment of infarct core and penumbra-Receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke. Stroke 37:979–985
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 2008 Springer-Verlag/Wien
About this paper
Cite this paper
Depreitere, B. et al. (2008). Study of perfusion in and around cerebral contusions by means of computed tomography. In: Steiger, H.J. (eds) Acta Neurochirurgica Supplements. Acta Neurochirurgica Supplementum, vol 102. Springer, Vienna. https://doi.org/10.1007/978-3-211-85578-2_49
Download citation
DOI: https://doi.org/10.1007/978-3-211-85578-2_49
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-85577-5
Online ISBN: 978-3-211-85578-2
eBook Packages: MedicineMedicine (R0)