Perfusion CT in Hyperacute Cerebral Hemorrhage Within3 Hours after Symptom Onset: Is There an EarlyPerihemorrhagic Penumbra?

摘要

INTRODUCTION In the recent years numerous studies have been undertaken to study cerebral perfusion inthe surrounding of intracerebral hemorrhage, addressing the question of whether there isa secondary ischemic damage. Most of these studies found a reduced perfusion adjacentto the hematoma. However, the meaning of these findings remains controversial. METHODS We used perfusion computed tomography in 17 patients to study time to peak, cerebralblood flow, and cerebral blood volume as markers of the perihemorrhagic perfusion within3 hours after symptom onset to search for an early difference between the extent of edemaand reduced perfusion.RESULTS All patients showed a significant reduction of all perfusion parameters in the perihemor-rhagic area, while there was no difference between the latitude of the reduced perfusionand the edema. CONCLUSION We did not find a difference between the extension of edema and that of restrictedperfusion at a very early time point and therefore could not identify any tissue at riskof ischemia. Our findings suggest reduced perfusion and edema to have a common causerather than presupposing one another.