Abstract
OBJECTIVE: Recent early cerebral blood flow (CBF) studies in cases of severe head injury have revealed ischemia in a substantial number of patients with a variety of computed tomographically demonstrated diagnoses. The underlying derangements causing this early ischemia are unknown, but cerebral blood volume (CBV) measurements might offer some insight into this pathological abnormality. METHODS: For this purpose, stable xenon-enhanced computed tomography was used for assessment of CBF, and a dynamic computed tomographic imaging technique was used for determining CBV. Based on the occurrence of regional ischemia (CBF < 20 ml/100 g/min), seven patients with varying anatomic lesions revealed by computed tomography were identified for comparison between CBF and CBV in ischemic and nonischemic areas. RESULTS: Both CBF (15 ± 4.3 versus 34 ± 11 g/min, P < 0.002) and CBV (2.5 ± 1.0 versus 4.9 ± 1.9 ml/100 g) exhibited significantly lower values in the ischemic zones than in the nonischemic zones (means ± standard deviations). Among 26 patients with or without ischemia observed during their initial follow-up studies, which were conducted between Days 2 and 8, all patients showed CBF and CBV values within the low-normal range. CONCLUSION: These data evidently support the suggestion that compromise of the microvasculature is the cause of early ischemia, rather than vasospasm of the larger conductance vessels.
Original language | English (US) |
---|---|
Pages (from-to) | 1276-1281 |
Number of pages | 6 |
Journal | Neurosurgery |
Volume | 42 |
Issue number | 6 |
DOIs | |
State | Published - Jun 1998 |
Keywords
- Cerebral blood flow
- Cerebral blood volume
- Head injury
- Ischemia
- Microvasculature
- Vasospasm
ASJC Scopus subject areas
- Clinical Neurology
- Surgery