Akademik Veri Yönetim Sistemi
Acta Neurochirurgica, Supplementum, sa.104, ss.245-248, 2008 (Scopus)
Early radiological diagnosis of vasospasm as well as the detection of ischemic areas and the definition of cerebral perfusion changes may have an impact on the current unfavorable results in patients with vasopasm. We investigated diffusion weighted (DW) and perfusion weighted (PW) magnetic resonance (MR) changes together with catheter angiography findings and tried to correlate radiological and clinical findings. Twenty patients (11 females, 9 males, 10-71 years old) with aneurysmal subarachnoid haemorrhage and admitted by the Neurosurgery Department at the Istanbul School of Medicine between December 2003 and March 2006 were included in the study. Thirteen patients were World Federation of Neurological Societies (WFNS) grade I and 7 were WFNS grade II on admission. All patients underwent angiography pre- and postoperatively. Cranial magnetic resonance imaging (MRI) with diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI) was performed in all patients. Radiological data was assessed by two neuroradiologists. All patients underwent surgery (13 microsurgical clipping, 7 coil embolization) for a total of 23 aneurysms. Angiographic vasospasm was detected in 14 patients and clinical vasospasm in 7. DWI and PWI abnormalities were detected in 12 patients. Perfusion MRI findings were classified as prolongation of time to peak (TTP) (normal, 2-4 sec, 4-6 sec and >6 sec). Reversibility was investigated on MR control scans. There was relatively good correlation between clinical and perfusion MR findings. Significant DWI abnormalities were not very frequent even in patients with clinical signs. DWI and PWI MR have provided an insight into hemodynamic and metabolic changes in vasospasm. Many issues are not yet clear and no study carried out so far is large enough for drawing significant conclusions. In this study, multimodality MR detected early ischemic changes in vasospasm. © 2008 Springer-Verlag.