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Comparison of perihematomal perfusion in deep and lobar intracerebral hemorrhage

Abstract

Purpose

Hypoperfusion in the perihematomal rim is common in acute intracerebral hemorrhage (ICH) but its determinants remain incompletely characterized. Despite known biological differences between deep and lobar ICH, the association between ICH location and cerebral perfusion has not been investigated. We tested the hypothesis that perihematomal perfusion differs between deep and lobar ICH.

Methods

Prospectively collected cohort of subjects with primary spontaneous ICH undergoing CT perfusion on admission. Cerebral blood flow (CBF), blood volume (CBV), and mean transit time (MTT) were measured in the manually outlined perihematomal low-density area. The association between perihematomal perfusion and ICH location was explored with multivariable linear regression.

Results

A total of 155 patients were enrolled (59 with a lobar bleeding). In univariate analysis, median perihematomal CBF and CBV were lower in lobar ICH compared with deep ICH (23.8 vs 33.4 mL/100 g/min, p = 0.001 and 1.7 vs 2.3 mL/100 g, p = 0.001, respectively). Lobar ICH location remained inversely associated with CBF (β = − 0.17, p = 0.038) and CBV (β = − 0.19, p = 0.023) after adjustment for confounders in linear regression.

Conclusion

Lobar ICH location is inversely related with perihematomal CBF and CBV. Further studies are needed to confirm this association and define the underlying biological mechanisms.

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Correspondence to Andrea Morotti.

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The authors declare that they have no conflict of interest.

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All procedures performed in the 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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Morotti, A., Busto, G., Bernardoni, A. et al. Comparison of perihematomal perfusion in deep and lobar intracerebral hemorrhage. Neuroradiology 62, 257–261 (2020). https://doi.org/10.1007/s00234-019-02331-9

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  • DOI: https://doi.org/10.1007/s00234-019-02331-9

Keywords

  • Intracerebral hemorrhage
  • Cerebral blood flow
  • CT perfusion
  • Hemorrhage location