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Correlation between gray matter volume loss followed by aneurysmal subarachnoid hemorrhage and subarachnoid hemorrhage volume

  • Diagnostic Neuroradiology
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Abstract

Purpose

Aneurysmal subarachnoid hemorrhage (SAH) can chronically affect cognitive function, and SAH has been suggested to result in regional brain damage. This study aimed to assess regional structural damage according to initial clinical status including SAH volume.

Methods

A total of 63 consecutive patients treated with coil embolization for intracranial aneurysms for more than 6 months were enrolled. Of these, 35 patients had SAH and 28 patients who were treated for unruptured aneurysms served as controls. Volumetric T1-weighted images were acquired with 1 mm isotropic voxel. The SAH volume was measured semi-automatically from the initial brain CT scan. Voxel-based group comparison was conducted to assess regional gray matter volume (GMV) changes. Voxel-based multiple regression was conducted to analyze regional GMV change and SAH volume. The clinical factors (Glasgow Coma Scale (GCS), SAH volume, systolic blood pressure, and serum laboratory findings) associated with regional GMV were also analyzed by using multiple regression.

Results

The SAH group had significantly lower GMV in the left hippocampus and higher GMV in the visual cortex than controls (Alphasim-corrected p < 0.05, voxel level of p < 0.001). The GMV of the bilateral hippocampi, thalami, and left medial orbital gyrus was negatively correlated with the initial SAH volume (FDR-corrected p < 0.05). SAH volume and GCS were associated with the hippocampal GMV in multiple regression (p < 0.05).

Conclusions

Chronic regional GMV change after SAH was related to the severity of initial clinical status including SAH volume. This finding supports the pathophysiological hypothesis of SAH-induced microstructural brain injury.

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Funding

This research was funded by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2017R1D1A1B03028952).

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Authors and Affiliations

  1. Department of Radiology, Kyung Hee University Medical Center, Seoul, South Korea

    Geon Yang Lee

  2. Department of Radiology, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, South Korea

    Chang-Woo Ryu & Geon-Ho Jahng

  3. College of Medicine, Kyung Hee University, Seoul, South Korea

    Chang-Woo Ryu & Geon-Ho Jahng

  4. Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea

    Hak Cheol Ko

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  1. Geon Yang Lee
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  2. Chang-Woo Ryu
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Correspondence to Chang-Woo Ryu.

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We declare that we have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Electronic supplementary material

Supplemental digital materials 1.

Table. Areas showing the GMV difference between controls, SAH group, and SAH subgroups (small and large SAH; low and high HH). Abbreviations: BA, Brodmann area; Lt, left; Rt, right; HH, Hunter-Hess scale (PDF 112 kb)

Supplemental digital materials 2.

Table. Areas showing decreased gray matter volumes negatively related with SAH volume. Abbreviations: BA, Brodmann area; Lt, left; Rt, right (PDF 214 kb)

Supplemental digital materials 3.

T1-weighted axial images and source images of TOF-MRA nearest to the coil mesh for all participants (PDF 1745 kb)

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Lee, G.Y., Ryu, CW., Ko, H.C. et al. Correlation between gray matter volume loss followed by aneurysmal subarachnoid hemorrhage and subarachnoid hemorrhage volume. Neuroradiology 62, 1401–1409 (2020). https://doi.org/10.1007/s00234-020-02445-5

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  • DOI: https://doi.org/10.1007/s00234-020-02445-5

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