Diffusion-weighted Magnetic Resonance Imaging in Patients with Subarachnoid Hemorrhage

Hadeishi, Hiromu; Suzuki, Akifumi; Yasui, Nobuyuki; Hatazawa, Jun; Shimosegawa, Eku

doi:10.1097/00006123-200204000-00010

Cited by 82 publications

(64 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…19 Additionally, patients with SAH may also have DW imaging changes, although these changes are often widespread in the cerebral cortex and tend to be associated with high-grade SAH (World Federation of Neurosurgical Societies Grade IV or V). 10 The clinically evident strokes were determined by chart review. A much stronger method would have been formal pre-and postprocedure assessments performed using the National Institutes of Health Stroke Scale.…”

Section: J Neurosurg / Volume 108 / June 2008mentioning

confidence: 99%

Frequency of thromboembolic events associated with endovascular aneurysm treatment: retrospective case series

Brooks

Turk

Niemann

et al. 2008

JNS

View full text Add to dashboard Cite

Object There is little evidence addressing whether procedures requiring adjunctive devices lead to an increased frequency of thromboembolic complications. The authors report their experience with 155 aneurysms treated with and without adjunctive devices. Methods The authors retrospectively reviewed their last 155 aneurysm coil placement procedures. The patients' records were reviewed for the following phenomena: 1) evidence of procedure-related thrombus formation; 2) clinical evidence of stroke; and 3) the presence of acute ischemia in the treated vascular territory on diffusion-weighted (DW) imaging. Results Of the 155 aneurysms treated in 132 patients, 66 were treated with coils only, 45 had stent-assisted coil placement, 33 underwent balloon remodeling, and in 11 stents were placed after balloon remodeling. Small DW imaging abnormalities were present in the treated vascular territory in 24% of cases (37 lesions). Specifically, 21 (32%) of 66 lesions in the coil-treated group, 6 (13%) of 45 in the stent-assisted coil treatment group, 8 (24%) of 33 in the balloon remodeling group, and 2 (18%) of 11 in the balloon and stent group showed DW imaging positivity. Furthermore, 25 (68%) of the 37 cases that were positive on DW imaging occurred in patients presenting with subarachnoid hemorrhage (SAH). Clinically evident stroke or transient ischemic attack was present in 10 (27%) of 37 cases, with 70% occurring in patients presenting with SAH. Conclusions Use of adjunctive devices in treating aneurysms does not appear to increase the frequency of embolic or ischemic events. The presence of DW imaging abnormalities and clinically evident stroke was actually less frequent when adjunctive devices were used and in electively treated cases. This was probably related to perioperative antiplatelet medical management.

show abstract

Section: J Neurosurg / Volume 108 / June 2008mentioning

confidence: 99%

Frequency of thromboembolic events associated with endovascular aneurysm treatment: retrospective case series

Brooks

Turk

Niemann

et al. 2008

JNS

View full text Add to dashboard Cite

show abstract

“…10) The pathological condition of cases with subarachnoid clots detected by diffusion-weighted MR imaging on admission remains to be elucidated. 7,10,20,27) In the present study, the overall rate of SAH detected by diffusion-weighted MR imaging on admission was 47%, and SAH was found in 40% of low-grade SAH patients, indicating no relationship to the severity of SAH. Moreover, the rate of detection was only 72% in patients in Fisher group 3.…”

Section: Diffusion-weighted Mr Imaging Findings In the Early Stagmentioning

confidence: 99%

“…Diffusionweighted MR imaging has been described as unsuitable for detecting clots in the subarachnoid space during acute stage SAH, 14,27) and could not reveal abnormalities in patients with good-grade SAH. 10) The present study investigates the clinical implications of subarachnoid clots detected by diffusionweighted MR imaging at the time of admission.…”

Section: Introductionmentioning

confidence: 99%

“…17,18) Conversely, diffusion-weighted MR imaging is useful for detecting intraparenchymal brain lesions, such as infarction after vasospasm 2,3,19,26) and direct brain damage caused by SAH. 1,7,10,20) However, the clinical conditions for the detection of subarachnoid clot in the acute stage of SAH by diffusion-weighted MR imaging remain to be elucidated. Diffusionweighted MR imaging has been described as unsuitable for detecting clots in the subarachnoid space during acute stage SAH, 14,27) and could not reveal abnormalities in patients with good-grade SAH.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Implications of Subarachnoid Clots Detected by Diffusion-Weighted Imaging in the Acute Stage of Aneurysm Rupture

Shimoda

Hoshikawa

Shiramizu

et al. 2010

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Diffusion-weighted magnetic resonance (MR) imaging findings of 72 patients with subarachnoid hemorrhage (SAH) in the acute stage were investigated to determine the clinical implications of subarachnoid clots detected by diffusion-weighted MR imaging on admission. Correlations between SAH detected by diffusion-weighted MR imaging and clinical factors were analyzed retrospectively. Diffusion-weighted MR imaging detected SAH in 34 of the 72 patients on admission. Thirty-three of 46 patients classified as Fisher group 3 had SAH detected by diffusion-weighted MR imaging. SAH detected by diffusion-weighted MR imaging on admission was significantly associated with both SAH imaging score and chronic hydrocephalus. SAH was detected by diffusion-weighted MR imaging on admission in patients who had dense clots. Detection of SAH by diffusion-weighted MR imaging was correlated with pathological conditions associated with the volume of subarachnoid clot, such as chronic hydrocephalus.

show abstract

“…Entre ellos destaca la gravedad del sangrado inicial por el importante peso que tiene en la evolución final de la enfermedad 47,125,126 . La hemorragia produce importantes y profundas reducciones del flujo sanguíneo cerebral asociadas a un incremento agudo de la presión intracraneal que desencadenan un daño isquémico que se puede mantener más allá de los primeros momentos del sangrado 84,144,162 . Estos procesos aunque cada vez más reconocidos no han encontrado todavía un tratamiento efectivo.…”

unclassified

Hemorragia subaracnoidea aneurismática: guía de tratamiento del Grupo de Patología Vascular de la Sociedad Española de Neurocirugía

et al. 2011

View full text Add to dashboard Cite

ResumenSe realiza una actualización sobre los aspectos más importantes de la hemorragia subaracnoidea aneurismática respecto a las guías previamente publicadas por el grupo de trabajo de la SENEC. Las recomendaciones propuestas deben considerarse como una guía general de manejo de esta patología. Sin embargo, pueden ser modificadas, incluso de manera significativa por las circunstancias propias de cada caso clínico, o las variaciones en los recursos diagnósticos y terapéuticos del centro hospitalario que reciba al paciente.PALABRAS CLAVE. Hemorragia subaracnoidea. Isquemia. Vasoespasmo. Aneurisma. Clip. Coil. Cirugía. SENEC. IntroducciónLa hemorragia subaracnoidea es una extravasación de sangre en el espacio subaracnoideo o leptomeníngeo. La causa más frecuente de hemorragia subaracnoidea es el traumatismo craneoencefálico. La hemorragia subaracnoidea primaria espontánea es con mayor frecuencia causada por la ruptura de un aneurisma cerebral, aunque existen otras causas como las malformaciones vasculares, tumores cerebrales, alteraciones de la pared vascular así como alteraciones de la coagulación. De un 15 a un 25% de los casos no se encuentra causa del sangrado constituyendo este grupo la hemorragia subaracnoidea idiopática cuyo pronóstico es mucho más benigno 70,123,127,176,188 . Esta guía trata sobre el manejo de los enfermos con hemorragia subaracnoidea aneurismática (HSA).La HSA supone del 6 al 8% de todas las enfermedades vasculares cerebrales agudas 116 , aunque su importancia radica en que afecta a pacientes de menor edad en general que el ictus isquémico y tiene una elevada morbi-mortalidad. Su incidencia no ha cambiado significativamente en los últimos años. Se han introducido nuevos métodos terapéuticos y cada vez más se usan protocolos que parecen haber mejorado la mortalidad general de esta enfermedad en las últimas décadas 159 . En el año 2000 se publicaron en la revista Neurocirugía las guías elaboradas por el Grupo de Patología vascular de la SENEC (GVAS) 178 . Aunque el tratamiento endovascular ya era utilizado y recomendado en la anterior edición de la guía, la aparición de nuevas evidencias sobre sus indicaciones y resultados, así como la necesidad y modo de seguimiento de los enfermos tratados mediante esta técnica, y por otro lado, la aparición de unas nuevas guías internacionales 22 , hizo que el GVAS decidiera revisar la versión anterior de estas guías.

show abstract

Diffusion-weighted Magnetic Resonance Imaging in Patients with Subarachnoid Hemorrhage

Abstract: DWI revealed widespread multifocal lesions in the cerebral cortex of acute poor-grade SAH patients. DWI provides accurate images of all areas of brain damage directly attributable to SAH.

Cited by 82 publications

References 21 publications

Frequency of thromboembolic events associated with endovascular aneurysm treatment: retrospective case series

Frequency of thromboembolic events associated with endovascular aneurysm treatment: retrospective case series

Clinical Implications of Subarachnoid Clots Detected by Diffusion-Weighted Imaging in the Acute Stage of Aneurysm Rupture

Hemorragia subaracnoidea aneurismática: guía de tratamiento del Grupo de Patología Vascular de la Sociedad Española de Neurocirugía

Contact Info

Product

Resources

About