Xenon-CT study of regional cerebral blood flow around hematoma in patients with basal ganglia hemorrhage

Abstract

Background. Xenon-CT is a quantitive technique for estimating cerebral blood flow. To investigate whether penumbra exists around hematoma, regional cerebral blood flow (rCBF) was measured by Xenon-CT in patients with intracerebral hemorrhage (ICH). Methods. Xenon-CT was performed on 15 patients with basal ganglia hemorrhage and hematoma volume <50mL. rCBF was measured within 36h of onset and an average of 13 days later by 27-pixel rings in perihematomal area and its enantiomorph in contralateral hemisphere. Penumbra was defined as rCBF 8-20mL.100g-1,min-1. Results. Average ICH volume was 13±7mL (6.4-23.7mL). First rCBF examination was conducted at 21.7±9.4h (5-37h), second rCBF examination was conducted at 13.4 ±1.8 days (11-18 days) after onset. Within 36 h of onset, mean perihematomal rCBF was 28.4±7.8mL.100g-1.min-1; contralateral region was 34.2 ± 12.2mL.100g-1.min-1 (p = 0.11). Average 13 days after onset, mean rCBF close to hematoma was 19.4 ± 8.1 mL-100g-1.min-1; rCBF in contralateral region was 40.1 ± 11.3mL-100g-1+.min-1 (p< 0.0001). rCBF in distal perihematomal region was 27.8 ± 9.5 mL. 100 -1.min-1; the difference was significant compared to contralateral region (p=0.0003). One patient's rCBF in area of edema around hematoma was less than 20mL-100g-1.min-1 at first examination. At second examination, 6 patients had same occurrence in region adjacent to hematoma and 2 patients experienced it in distal perihematomal region. Conclusions. Reduced perihematomal rCBF was shown after ICH; this phenomenon lasted at least 14 days. A number of ICH patients experienced penumbra around hematoma. © 2008 Springer-Verlag.