Symptomatic vasospasm after subarachnoid haemorrhage: assessment of brain damage by diffusion and perfusion-weighted MRI and single-photon emission computed tomography

Our purpose was to assess the usefulness of diffusion- and perfusion-weighted MRI for the detection of ischaemic brain damage in patients with suspected vasospasm after subarachnoid haemorrhage (SAH). We studied 11 patients admitted with a ruptured aneurysm of the anterior circulation and suspected...

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Bibliographic Details
Published in:Neuroradiology 2002-07, Vol.44 (7), p.610-616
Main Authors: LECLERC, X, FICHTEN, A, GAUVRIT, J. Y, RIEGEL, B, STEINLING, M, LEJEUNE, J. P, PRUVO, J. P
Format: Article
Language:English
Subjects:
Adult
Aneurysm, Ruptured - complications
Biological and medical sciences
Blood Flow Velocity
Brain - diagnostic imaging
Brain - pathology
Cerebrovascular Circulation
Female
Humans
Intracranial Aneurysm - complications
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Neurology
Radiopharmaceuticals
Subarachnoid Hemorrhage - complications
Subarachnoid Hemorrhage - diagnosis
Subarachnoid Hemorrhage - diagnostic imaging
Technetium Tc 99m Exametazime
Tomography, Emission-Computed, Single-Photon
Ultrasonography, Doppler, Transcranial
Vascular diseases and vascular malformations of the nervous system
Vasospasm, Intracranial - diagnosis
Vasospasm, Intracranial - diagnostic imaging
Vasospasm, Intracranial - etiology
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Summary:Our purpose was to assess the usefulness of diffusion- and perfusion-weighted MRI for the detection of ischaemic brain damage in patients with suspected vasospasm after subarachnoid haemorrhage (SAH). We studied 11 patients admitted with a ruptured aneurysm of the anterior circulation and suspected of intracranial vasospasm on clinical examination and transcranial Doppler sonography (TCD). All were investigated by technetium-hexamethyl-propylene amine oxime (Tc-HMPAO) single photon emission computed tomography (SPECT) and diffusion and perfusion-weighted MRI (DWI, PWI) within 2 weeks of their SAH. Trace images and TTP maps were interpreted by two examiners and compared with clinical and imaging follow-up. PWI revealed an area of slowed flow in seven patients, including four with major and three with minor hypoperfusion on SPECT. In two patients, PWI did not demonstrate any abnormality, while SPECT revealed major hypoperfusion in one and a minor deficit hypoperfusion in the other. Two patients with high signal on DWI had a permanent neurological deficit.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-002-0745-7