TY - JOUR
T1 - Association of quantified location-specific blood volumes with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage
AU - van der Steen, W. E.
AU - Zijlstra, I. A.
AU - Verbaan, D.
AU - Boers, A. M. M.
AU - Gathier, C. S.
AU - van den Berg, R.
AU - Rinkel, G. J. E.
AU - Coert, B. A.
AU - Roos, Y. B. W. E. M.
AU - Majoie, C. B. L. M.
AU - Marquering, H. A.
PY - 2018
Y1 - 2018
N2 - BACKGROUND AND PURPOSE: Delayed cerebral ischemia is a severe complication of aneurysmal SAH and is associated with a high case morbidity and fatality. The total blood volume and the presence of intraventricular blood on CT after aneurysmal SAH are associated with delayed cerebral ischemia. Whether quantified location-specific (cisternal, intraventricular, parenchymal, and subdural) blood volumes are associated with delayed cerebral ischemia has been infrequently researched. This study aimed to associate quantified location-specific blood volumes with delayed cerebral ischemia. MATERIALS AND METHODS: Clinical and radiologic data were collected retrospectively from consecutive patients with aneurysmal SAH with available CT scans within 24 hours after ictus admitted to 2 academic centers between January 2009 and December 2011. Total blood volume was quantified using an automatic hemorrhage-segmentation algorithm. Segmented blood was manually classified as cisternal, intraventricular, intraparenchymal, or subdural. Adjusted ORs with 95% confidence intervals for delayed cerebral ischemia per milliliter of location-specific blood were calculated using multivariable logistic regression analysis. RESULTS: We included 282 patients. Per milliliter increase in blood volume, the adjusted OR for delayed cerebral ischemia was 1.02 (95% CI, 1.01–1.04) for cisternal, 1.02 (95% CI, 1.00 –1.04) for intraventricular, 0.99 (95% CI, 0.97–1.02) for intraparenchymal, and 0.96 (95% CI, 0.86 –1.07) for subdural blood. CONCLUSIONS: Our findings suggest that in patients with aneurysmal subarachnoid hemorrhage, the cisternal blood volume has a stronger relation with delayed cerebral ischemia than the blood volumes at other locations in the brain.
AB - BACKGROUND AND PURPOSE: Delayed cerebral ischemia is a severe complication of aneurysmal SAH and is associated with a high case morbidity and fatality. The total blood volume and the presence of intraventricular blood on CT after aneurysmal SAH are associated with delayed cerebral ischemia. Whether quantified location-specific (cisternal, intraventricular, parenchymal, and subdural) blood volumes are associated with delayed cerebral ischemia has been infrequently researched. This study aimed to associate quantified location-specific blood volumes with delayed cerebral ischemia. MATERIALS AND METHODS: Clinical and radiologic data were collected retrospectively from consecutive patients with aneurysmal SAH with available CT scans within 24 hours after ictus admitted to 2 academic centers between January 2009 and December 2011. Total blood volume was quantified using an automatic hemorrhage-segmentation algorithm. Segmented blood was manually classified as cisternal, intraventricular, intraparenchymal, or subdural. Adjusted ORs with 95% confidence intervals for delayed cerebral ischemia per milliliter of location-specific blood were calculated using multivariable logistic regression analysis. RESULTS: We included 282 patients. Per milliliter increase in blood volume, the adjusted OR for delayed cerebral ischemia was 1.02 (95% CI, 1.01–1.04) for cisternal, 1.02 (95% CI, 1.00 –1.04) for intraventricular, 0.99 (95% CI, 0.97–1.02) for intraparenchymal, and 0.96 (95% CI, 0.86 –1.07) for subdural blood. CONCLUSIONS: Our findings suggest that in patients with aneurysmal subarachnoid hemorrhage, the cisternal blood volume has a stronger relation with delayed cerebral ischemia than the blood volumes at other locations in the brain.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85048658123&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29650786
U2 - https://doi.org/10.3174/ajnr.A5626
DO - https://doi.org/10.3174/ajnr.A5626
M3 - Article
C2 - 29650786
SN - 0195-6108
VL - 39
SP - 1059
EP - 1064
JO - AJNR. American journal of neuroradiology
JF - AJNR. American journal of neuroradiology
IS - 6
ER -