Object:This study is designed to estimate the clinical usefulness of perfusion computed tomography (perfusion CT) as an easily accessible tool to evaluate cerebral blood flow (CBF) in patients with aneurysmal subarachnoid hemorrhage. Method:Twenty patients with aneurysmal spontaneous subarachnoid hemorrhage who underwent either aneurysmal neck clipping or interventional coil embolization and who also had taken transcranial doppler study and perfusion CT were included as study group. And as a control group, fifteen patients without neurologic deficit were studied with the same devices. We compared the cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) from obtained perfusion CT with the results of transcranial doppler and clinical course. Results:CBF parameters of perfusion CT in control group showed close accordance with those values of reported xenon CT and positron emission tomography data. In doppler study, the blood flow velocity was higher in cases with vasospasm than without it (p=0.027). There showed significant relationship between vasospasm and perfusion CT parameters, as decrease in CBF (p=0.061) and increase in MTT (p=0.013). Perfusion CT parameters were closely correlated with TCD parameters in clinical vasospasm as reverse correlation in CBF (R=0.45) and positive in MTT (R=0.58). Conclusion:The cerebral blood flow parameters of Perfusion CT showed reliable and accurate values in control group. The perfusion CT and TCD can be used as easily accessible non-invasive tools to evaluate cerebral blood flow parameters in clinical settings of patients with aneurysmal subarachnoid hemorrhage. (Kor J Cerebrovascular Surgery 7:48-53, 2005)

Perfusion Computed Tomography and Trancranial Doppler in Aneurysmal Subarachnoid Hemorrhage.

Objective : We have investigated the risk factors associated with angiographic recurrence of intracranial aneurysms after endovascular coil embolization in a retrospective manner. Methods : From January 2000 to June 2005, 128 aneurysms in 114 patients were treated with coil embolization. Among them, 54 aneurysms in 51 patients were followed by repeated intraarterial angiography at 6, 12, 18, and 24 months post-embolization. Recurrence was defined when either coil compaction or aneurysm regrowth was identified on follow-up angiography. Patients were divided into stable and recurred groups according to angiographic recurrence. Clinical parameters, anatomical factors, and the degree of occlusion were retrospectively reviewed. Results : The overall recurrence rate was 29% in our study. The diameter of the largest dimension of the fundus was larger in the recurred group of patients as compared to the stable group of patients (7.33±2.26 mm vs. 5.87± 1.93mm, p = 0.048), and a significant rate of recurrence was seen in fundus size of the same or greater than 10 mm (41.7% vs 14.3%, p = 0.038). The coil packing density was significantly smaller in the recurred group of patients (p = 0.002), with a recurrence rate of 47.0% in cases with a coil packing density below 25% (p = 0.017). Conclusions : Our study showed that maximum aneurysm fundus size and coil packing density had a close correlation to recurrence. However, a larger number of patients with longer observation times may be needed to define the risk factors affecting angiographic recurrence. (Kor J Cerebrovascular Surgery 9(4):231-7, 2007)

Angiographic Recurrence after Endovascular Coil Embolization for Intracranial Aneurysm.

First-Pass Perfusion Computed Tomography and Transcranial Doppler in Hydrocephalus.

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Perfusion Computed Tomography and Trancranial Doppler in Aneurysmal Subarachnoid Hemorrhage.

Angiographic Recurrence after Endovascular Coil Embolization for Intracranial Aneurysm.

First-Pass Perfusion Computed Tomography and Transcranial Doppler in Hydrocephalus.