ArticleNeurosurgical review2020
Defining cutoff values for early prediction of delayed cerebral ischemia after subarachnoid hemorrhage by CT perfusion.
Article in Neurosurgical review, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- European Stroke Organisation (ESO), European Association of Neurosurgical Societies (EANS) and European Society for Minimally Invasive Neurological Therapy (ESMINT) guideline on aneurysmal subarachnoid haemorrhage.European stroke journal · 2026Guideline
- CTP for the Screening of Vasospasm and Delayed Cerebral Ischemia in Aneurysmal SAH: A Systematic Review and Meta-analysis.AJNR. American journal of neuroradiology · 2024Pooled it
- The value of early CT perfusion parameters for predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.Neurosurgical review · 2022Pooled it
- Prediction and Risk Assessment Models for Subarachnoid Hemorrhage: A Systematic Review on Case Studies.BioMed research international · 2022Pooled it
- Association Between Spreading Depolarization and Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: Post Hoc Analysis of a Randomized Trial of the Effect of Cilostazol on Delayed Cerebral Ischemia.Neurocritical care · 2021Trial
- Territorial CT Perfusion Burden and Outcome After Aneurysmal Subarachnoid Haemorrhage: A Retrospective Single-Centre Cohort Study.Diagnostics (Basel, Switzerland) · 2026Article
- Time-to-maximum Analysis Using Rapid Processing of Perfusion and Diffusion Software for Assessment of the Risk of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage.Neurologia medico-chirurgica · 2026Article
- Comparison of non-contrast CT, CT perfusion, and CT angiography for predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Insights into imaging · 2026Article
- Detection of Subarachnoid Hemorrhage Using CNN with Dynamic Factor and Wandering Strategy-Based Feature Selection.Diagnostics (Basel, Switzerland) · 2024Article
- Early localization of tissue at risk for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: blood distribution on initial imaging vs early CT perfusion.Neurosurgical review · 2024Article
- CT perfusion imaging in aneurysmal subarachnoid hemorrhage. State of the art.Frontiers in radiology · 2024Review
- The value of comorbidities and illness severity scores as prognostic tools for early outcome estimation in patients with aneurysmal subarachnoid hemorrhage.Neurosurgical review · 2022Article
- Vasospasm-Related Death after Aneurysmal Subarachnoid Hemorrhage: A Retrospective Case-Control Study.Journal of clinical medicine · 2022Article
- Radiation Exposure in the Acute Phase after Aneurysmal Subarachnoid Hemorrhage in the Era of CT Perfusion.Clinical neuroradiology · 2022Article
- The Role of ET-1 in Early Cerebral Microcirculation Changes after Subarachnoid Hemorrhage.Journal of healthcare engineering · 2022Article
- The Impact of Endovascular Rescue Therapy on the Clinical and Radiological Outcome After Aneurysmal Subarachnoid Hemorrhage: A Safe and Effective Treatment Option for Hemodynamically Relevant Vasospasm?Frontiers in neurology · 2022Article
- Cerebral circulation time on DSA during endovascular treatment in WFNS grade I aneurysmal SAH patients-a predictor of DCI?Neuroradiology · 2021Article
- Impact of Implementing an Elaborated CT Perfusion Protocol for Aneurysmal SAH on Functional Outcome: CTP Protocol for SAH.AJNR. American journal of neuroradiology · 2021Article
- The effectiveness of lumbar cerebrospinal fluid drainage in aneurysmal subarachnoid hemorrhage with different bleeding amounts.Neurosurgical review · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Early prediction of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is essential to prevent infarction. CT perfusion (CTP) is used to identify perfusion deficits and to guide treatment decisions. In this study, we aimed to evaluate CTP parameters and to establish cutoff values for DCI prediction in the early phase after aSAH. Whole-brain CTP was performed on day 3 after aSAH. These CTP parameters were analyzed: cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), time to start (TTS), and time to drain (TTD). ROC analysis was performed to establish cutoff values. The outcome (modified Rankin scale (mRS)) at 3 months follow-up and the DCI incidence were evaluated. A total of 64 patients were included. A good WFNS grade (I-III) was documented in 44% of the patients. A mild modified Fisher grade (1-2) was seen in 3% of the patients. Early perfusion deficits were found in 18 of 64 patients and 10 of them developed DCI. For DCI prediction, the following cutoff values were identified: TTD > 4.93 s, CBF < 53.93 ml/100 ml/min, MTT <> 4.25 s, TTS > 0.94 s, TTP > 9.28 s, and CBV < 3.14 ml/100 ml. The positive predictive value (PPV)/negative PV (NPV) was as follows: TTD 77%/93%; CBF 94%/70%; MTT 72%/96%; TTS 71%/86%; TTP 55%/78%; CBV 75%/61%. Early perfusion deficits correlated with DCI (logistic regression p < 0.0001) but not with outcome. CTP on day 3 after aSAH allows reliable DCI prediction. TTD had high NPV/PPV for DCI prediction and should be an integral part of quantitative CTP analysis in the early phase after aSAH.
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