OBJECTIVES: To evaluate the relation between brain displacement, clinical signs and symptoms, and local cerebral blood flow (lCBF) in patients with chronic subdural haematoma (CSDH). METHODS: Forty five patients (age range 58-87 years, mean 71.9 (SD 8.4)) with unilateral CSDH were studied. Patients were categorised into three groups: I, headache (n=16); II, paresis (n=14); and III, mental change (n=15). T1 weighted MR images were obtained in all patients preoperatively. Quantitative values of maximum haematoma thickness, midline shift, and brain rotation angle were measured on axial and coronal MR images. In 21 patients, lCBF was measured by Xe enhanced CT. Values for lCBF were obtained in selected regions of interest in the frontal cortex, thalamus, and hemisphere on both the haematoma and contralateral sides. RESULTS: The lCBF reduction in the ipsilateral frontal cortex showed the best linear correlation with haematoma thickness (r=0.57), whereas the reduction in the ipsilateral thalamus had the most significant correlation with pineal shift (r=0.65) and third ventricle incline (r=0.67). In patients with paresis, lCBF decreased significantly on the ipsilateral side of both the frontal cortex and thalamus (p<0.05), whereas patients with mental change showed a significant reduction of lCBF on both sides of the thalamus (p<0.01) and in the ipsilateral frontal cortex (p<0.01). CONCLUSIONS: The lCBF reduction and clinical symptoms correlated well with local brain displacement in patients with CSDH. The lCBF in the central cerebral area including the thalamus was reduced in patients with clinical signs. The mental changes found were thought to derive from mild impairment of consciousness due to upper brain stem displacement.
OBJECTIVES: To evaluate the relation between brain displacement, clinical signs and symptoms, and local cerebral blood flow (lCBF) in patients with chronic subdural haematoma (CSDH). METHODS: Forty five patients (age range 58-87 years, mean 71.9 (SD 8.4)) with unilateral CSDH were studied. Patients were categorised into three groups: I, headache (n=16); II, paresis (n=14); and III, mental change (n=15). T1 weighted MR images were obtained in all patients preoperatively. Quantitative values of maximum haematoma thickness, midline shift, and brain rotation angle were measured on axial and coronal MR images. In 21 patients, lCBF was measured by Xe enhanced CT. Values for lCBF were obtained in selected regions of interest in the frontal cortex, thalamus, and hemisphere on both the haematoma and contralateral sides. RESULTS: The lCBF reduction in the ipsilateral frontal cortex showed the best linear correlation with haematoma thickness (r=0.57), whereas the reduction in the ipsilateral thalamus had the most significant correlation with pineal shift (r=0.65) and third ventricle incline (r=0.67). In patients with paresis, lCBF decreased significantly on the ipsilateral side of both the frontal cortex and thalamus (p<0.05), whereas patients with mental change showed a significant reduction of lCBF on both sides of the thalamus (p<0.01) and in the ipsilateral frontal cortex (p<0.01). CONCLUSIONS: The lCBF reduction and clinical symptoms correlated well with local brain displacement in patients with CSDH. The lCBF in the central cerebral area including the thalamus was reduced in patients with clinical signs. The mental changes found were thought to derive from mild impairment of consciousness due to upper brain stem displacement.
Authors: K Yoshida; M Furuse; A Izawa; N Iizima; T Hirano; H Kuchiwaki; S Inao; K Sugita Journal: AJNR Am J Neuroradiol Date: 1994-10 Impact factor: 3.825
Authors: K Yokoyama; M Matsuki; H Shimano; S Sumioka; T Ikenaga; K Hanabusa; S Yasuda; H Inoue; T Watanabe; M Miyashita; R Hiramatsu; K Murao; A Kondo; H Tanabe; T Kuroiwa Journal: AJNR Am J Neuroradiol Date: 2008-03-20 Impact factor: 3.825
Authors: Daniel J Stubbs; Benjamin M Davies; Tom Bashford; Alexis J Joannides; Peter J Hutchinson; David K Menon; Ari Ercole; Rowan M Burnstein Journal: BMJ Open Date: 2020-06-30 Impact factor: 2.692
Authors: Ellie Edlmann; Eric P Thelin; Karen Caldwell; Carole Turner; Peter Whitfield; Diederik Bulters; Patrick Holton; Nigel Suttner; Kevin Owusu-Agyemang; Yahia Z Al-Tamimi; Daniel Gatt; Simon Thomson; Ian A Anderson; Oliver Richards; Monica Gherle; Emma Toman; Dipankar Nandi; Phillip Kane; Beatrice Pantaleo; Carol Davis-Wilkie; Silvia Tarantino; Garry Barton; Hani J Marcus; Aswin Chari; Antonio Belli; Simon Bond; Rafael Gafoor; Sarah Dawson; Lynne Whitehead; Paul Brennan; Ian Wilkinson; Angelos G Kolias; Peter J A Hutchinson Journal: Sci Rep Date: 2019-04-10 Impact factor: 4.379