Comparison of cerebral blood flow in computed tomographic hypodense areas of the brain in head-injured patients

Yu Furuya, Roman Hlatky, Alex B. Valadka, Pedro Diaz, Claudia S. Robertson, Ross Bullock, J. Paul Muizelaar, Daniel F. Kelly, Jack E. Wilberger

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVE: Hypodense lesions identified on computed tomographic (CT) scans are often assumed to indicate ischemia. The purpose of this study was to investigate regional cerebral blood flow (rCBF) in hypodense areas of the brain after severe traumatic brain injury. METHODS: CBF was measured by stable xenon-enhanced CT scans. Hypodense areas were identified, and rCBF values as well as CT density were averaged for the region. RESULTS: Thirty (60%) of the 50 patients had a total of 45 hypodense regions, which were associated with either contusion (n = 30) or areas of infarction (n = 15). rCBF in the hypodense regions was variable, ranging from a low of 3.3 to a high of 72.5 ml/100 g/min. The cause of the lesion was the major factor associated with the level of rCBF. Although the average decrease in CT density was similar for the two types of lesions, the average rCBF was significantly lower and the difference in rCBF between the lesion and the contralateral side was greater when the hypodense lesion was associated with a contusion. A critical reduction in rCBF (<20 ml/100 g/min) was found in 19 (63%) of the hypodense regions associated with contusions but in only 4 (27%) of those from areas of infarction. CONCLUSION: Hypodensity on plain CT scans does not always indicate reduction in CBF. This association was found more commonly when the low-density area was associated with a contusion. In hypodense areas associated with infarction, rCBF was variable and not commonly in the ischemic range at the time the CBF measurement was obtained.

Original languageEnglish
Pages (from-to)340-346
Number of pages7
JournalNeurosurgery
Volume52
Issue number2
StatePublished - Feb 1 2003
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Regional Blood Flow
Head
Contusions
Brain
Infarction
Xenon
Ischemia

Keywords

  • Brain contusion
  • Brain ischemia
  • Cerebral blood flow
  • Computed tomography
  • Head injury
  • Xenon-enhanced computed tomography

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Furuya, Y., Hlatky, R., Valadka, A. B., Diaz, P., Robertson, C. S., Bullock, R., ... Wilberger, J. E. (2003). Comparison of cerebral blood flow in computed tomographic hypodense areas of the brain in head-injured patients. Neurosurgery, 52(2), 340-346.

Comparison of cerebral blood flow in computed tomographic hypodense areas of the brain in head-injured patients. / Furuya, Yu; Hlatky, Roman; Valadka, Alex B.; Diaz, Pedro; Robertson, Claudia S.; Bullock, Ross; Muizelaar, J. Paul; Kelly, Daniel F.; Wilberger, Jack E.

In: Neurosurgery, Vol. 52, No. 2, 01.02.2003, p. 340-346.

Research output: Contribution to journalArticle

Furuya, Y, Hlatky, R, Valadka, AB, Diaz, P, Robertson, CS, Bullock, R, Muizelaar, JP, Kelly, DF & Wilberger, JE 2003, 'Comparison of cerebral blood flow in computed tomographic hypodense areas of the brain in head-injured patients', Neurosurgery, vol. 52, no. 2, pp. 340-346.
Furuya Y, Hlatky R, Valadka AB, Diaz P, Robertson CS, Bullock R et al. Comparison of cerebral blood flow in computed tomographic hypodense areas of the brain in head-injured patients. Neurosurgery. 2003 Feb 1;52(2):340-346.
Furuya, Yu ; Hlatky, Roman ; Valadka, Alex B. ; Diaz, Pedro ; Robertson, Claudia S. ; Bullock, Ross ; Muizelaar, J. Paul ; Kelly, Daniel F. ; Wilberger, Jack E. / Comparison of cerebral blood flow in computed tomographic hypodense areas of the brain in head-injured patients. In: Neurosurgery. 2003 ; Vol. 52, No. 2. pp. 340-346.
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abstract = "OBJECTIVE: Hypodense lesions identified on computed tomographic (CT) scans are often assumed to indicate ischemia. The purpose of this study was to investigate regional cerebral blood flow (rCBF) in hypodense areas of the brain after severe traumatic brain injury. METHODS: CBF was measured by stable xenon-enhanced CT scans. Hypodense areas were identified, and rCBF values as well as CT density were averaged for the region. RESULTS: Thirty (60{\%}) of the 50 patients had a total of 45 hypodense regions, which were associated with either contusion (n = 30) or areas of infarction (n = 15). rCBF in the hypodense regions was variable, ranging from a low of 3.3 to a high of 72.5 ml/100 g/min. The cause of the lesion was the major factor associated with the level of rCBF. Although the average decrease in CT density was similar for the two types of lesions, the average rCBF was significantly lower and the difference in rCBF between the lesion and the contralateral side was greater when the hypodense lesion was associated with a contusion. A critical reduction in rCBF (<20 ml/100 g/min) was found in 19 (63{\%}) of the hypodense regions associated with contusions but in only 4 (27{\%}) of those from areas of infarction. CONCLUSION: Hypodensity on plain CT scans does not always indicate reduction in CBF. This association was found more commonly when the low-density area was associated with a contusion. In hypodense areas associated with infarction, rCBF was variable and not commonly in the ischemic range at the time the CBF measurement was obtained.",
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AU - Hlatky, Roman

AU - Valadka, Alex B.

AU - Diaz, Pedro

AU - Robertson, Claudia S.

AU - Bullock, Ross

AU - Muizelaar, J. Paul

AU - Kelly, Daniel F.

AU - Wilberger, Jack E.

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N2 - OBJECTIVE: Hypodense lesions identified on computed tomographic (CT) scans are often assumed to indicate ischemia. The purpose of this study was to investigate regional cerebral blood flow (rCBF) in hypodense areas of the brain after severe traumatic brain injury. METHODS: CBF was measured by stable xenon-enhanced CT scans. Hypodense areas were identified, and rCBF values as well as CT density were averaged for the region. RESULTS: Thirty (60%) of the 50 patients had a total of 45 hypodense regions, which were associated with either contusion (n = 30) or areas of infarction (n = 15). rCBF in the hypodense regions was variable, ranging from a low of 3.3 to a high of 72.5 ml/100 g/min. The cause of the lesion was the major factor associated with the level of rCBF. Although the average decrease in CT density was similar for the two types of lesions, the average rCBF was significantly lower and the difference in rCBF between the lesion and the contralateral side was greater when the hypodense lesion was associated with a contusion. A critical reduction in rCBF (<20 ml/100 g/min) was found in 19 (63%) of the hypodense regions associated with contusions but in only 4 (27%) of those from areas of infarction. CONCLUSION: Hypodensity on plain CT scans does not always indicate reduction in CBF. This association was found more commonly when the low-density area was associated with a contusion. In hypodense areas associated with infarction, rCBF was variable and not commonly in the ischemic range at the time the CBF measurement was obtained.

AB - OBJECTIVE: Hypodense lesions identified on computed tomographic (CT) scans are often assumed to indicate ischemia. The purpose of this study was to investigate regional cerebral blood flow (rCBF) in hypodense areas of the brain after severe traumatic brain injury. METHODS: CBF was measured by stable xenon-enhanced CT scans. Hypodense areas were identified, and rCBF values as well as CT density were averaged for the region. RESULTS: Thirty (60%) of the 50 patients had a total of 45 hypodense regions, which were associated with either contusion (n = 30) or areas of infarction (n = 15). rCBF in the hypodense regions was variable, ranging from a low of 3.3 to a high of 72.5 ml/100 g/min. The cause of the lesion was the major factor associated with the level of rCBF. Although the average decrease in CT density was similar for the two types of lesions, the average rCBF was significantly lower and the difference in rCBF between the lesion and the contralateral side was greater when the hypodense lesion was associated with a contusion. A critical reduction in rCBF (<20 ml/100 g/min) was found in 19 (63%) of the hypodense regions associated with contusions but in only 4 (27%) of those from areas of infarction. CONCLUSION: Hypodensity on plain CT scans does not always indicate reduction in CBF. This association was found more commonly when the low-density area was associated with a contusion. In hypodense areas associated with infarction, rCBF was variable and not commonly in the ischemic range at the time the CBF measurement was obtained.

KW - Brain contusion

KW - Brain ischemia

KW - Cerebral blood flow

KW - Computed tomography

KW - Head injury

KW - Xenon-enhanced computed tomography

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