Early CT perfusion measurement after aneurysmal subarachnoid hemorrhage: a screening method to predict outcome?

Objective: The goal of the present study is to analyze the predictive impact of early CT-based perfusion measurement (CTP) on clinical outcome in patients suffering from aneurysmal SAH.

Methods: Fifteen patients with aneurysmal SAH received an early CTP measurement that was performed within the first 6 h after initial bleeding. According to a specific CTP protocol, mean transit time (MTT) and time to peak (TTP) were calculated bihemispherically and correlated with the clinical initial status according to the WFNS grade as well as with the Glasgow Outcome Scale (GOS) at the time of discharge.

Results: The MTT and TTP correlated highly significantly with the initial WFNS grade and the GOS at the time of discharge. Mean bihemispheric MTT was 3.4 s (2.8-4.1 s, SD: 0.5 s) for initially good-grade patients (WFNS° I-III) and 4.5 s (31.2-49.8 s) for poor-grade patients (WFNS° IV-V). ICP monitored in nine patients via EVD was documented within normal intracranial pressure as defined below 18 mmHg.

Conclusion: The determination of MTT and TTP using early CTP measurements in patients suffering from aneurysmal SAH demonstrated a significant correlation with the initial neurological status and the early clinical outcome.