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PT  - JOURNAL ARTICLE
AU  - van der Steen, W.E.
AU  - Zijlstra, I.A.
AU  - Verbaan, D.
AU  - Boers, A.M.M.
AU  - Gathier, C.S.
AU  - van den Berg, R.
AU  - Rinkel, G.J.E.
AU  - Coert, B.A.
AU  - Roos, Y.B.W.E.M.
AU  - Majoie, C.B.L.M.
AU  - Marquering, H.A.
TI  - Association of Quantified Location-Specific Blood Volumes with Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage
AID  - 10.3174/ajnr.A5626
DP  - 2018 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1059--1064
VI  - 39
IP  - 6
4099  - http://www.ajnr.org/content/39/6/1059.short
4100  - http://www.ajnr.org/content/39/6/1059.full
SO  - Am. J. Neuroradiol.2018 Jun 01; 39
AB  - BACKGROUND AND PURPOSE: Delayed cerebral ischemia is a severe complication of aneurysmal SAH and is associated with a high case morbidity and fatality. The total blood volume and the presence of intraventricular blood on CT after aneurysmal SAH are associated with delayed cerebral ischemia. Whether quantified location-specific (cisternal, intraventricular, parenchymal, and subdural) blood volumes are associated with delayed cerebral ischemia has been infrequently researched. This study aimed to associate quantified location-specific blood volumes with delayed cerebral ischemia.MATERIALS AND METHODS: Clinical and radiologic data were collected retrospectively from consecutive patients with aneurysmal SAH with available CT scans within 24 hours after ictus admitted to 2 academic centers between January 2009 and December 2011. Total blood volume was quantified using an automatic hemorrhage-segmentation algorithm. Segmented blood was manually classified as cisternal, intraventricular, intraparenchymal, or subdural. Adjusted ORs with 95% confidence intervals for delayed cerebral ischemia per milliliter of location-specific blood were calculated using multivariable logistic regression analysis.RESULTS: We included 282 patients. Per milliliter increase in blood volume, the adjusted OR for delayed cerebral ischemia was 1.02 (95% CI, 1.01–1.04) for cisternal, 1.02 (95% CI, 1.00–1.04) for intraventricular, 0.99 (95% CI, 0.97–1.02) for intraparenchymal, and 0.96 (95% CI, 0.86–1.07) for subdural blood.CONCLUSIONS: Our findings suggest that in patients with aneurysmal subarachnoid hemorrhage, the cisternal blood volume has a stronger relation with delayed cerebral ischemia than the blood volumes at other locations in the brain.aORadjusted odds ratioaSAHaneurysmal subarachnoid hemorrhageDCIdelayed cerebral ischemiaIPHintraparenchymal hemorrhageIVHintraventricular hemorrhageSDHsubdural hemorrhageWFNSWorld Federation of Neurosurgical Societies