ArticleStroke2021
Automated Quantification of Reduced Sulcal Volume Identifies Early Brain Injury After Aneurysmal Subarachnoid Hemorrhage.
Article in Stroke, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 24 citations in OpenAlex.
- Quantification of blood and CSF volume to predict outcome after aneurysmal subarachnoid hemorrhage.Neurosurgical review · 2024Trial
- A 90-Day Prognostic Model Based on the Early Brain Injury Indicators after Aneurysmal Subarachnoid Hemorrhage: the TAPS Score.Translational stroke research · 2023Trial
- Association of Impaired Hematoma Clearance After Aneurysmal Subarachnoid Hemorrhage with Delayed Cerebral Ischemia, Hydrocephalus, and Long-Term Outcomes.Neurocritical care · 2026Article
- A Platform for Automatic Extraction of Imaging Biomarkers in CT Scans from Ischemic and Hemorrhagic Stroke Patients.Journal of imaging informatics in medicine · 2026Article
- Utilizing Artificial Intelligence for CSF Segmentation and Analysis in Head CT Imaging: A Systematic Review.Brain sciences · 2025Review
- Early Microcirculatory Dysfunction on Perfusion CT Is Related to Prognosis After Aneurysmal Subarachnoid Hemorrhage.Translational stroke research · 2025Article
- Volumetric Assessment of Perimesencephalic Subarachnoid Hemorrhage.Neurology and therapy · 2025Article
- Aging Leads to Poor Outcome after Subarachnoid Hemorrhage through Exacerbating Early Brain Injury.Neurologia medico-chirurgica · 2025Article
- Impact of Microcirculatory Dysfunction on Persistent Global Cerebral Edema After Aneurysmal Subarachnoid Hemorrhage: An Age-Stratified Analysis.Neurocritical care · 2025Article
- Pathophysiological mechanisms underlying early brain injury and delayed cerebral ischemia in the aftermath of aneurysmal subarachnoid hemorrhage: a comprehensive analysis.Frontiers in neurology · 2025Review
- Update on Strategies to Reduce Early Brain Injury after Subarachnoid Hemorrhage.Current neurology and neuroscience reports · 2024Review
- Early and delayed blood-brain barrier permeability predicts delayed cerebral ischemia and outcomes following aneurysmal subarachnoid hemorrhage.European radiology · 2024Article
- Article
- Schizandrin A attenuates early brain injury following subarachnoid hemorrhage through suppressing neuroinflammation.Molecular biology reports · 2024Article
- Should individual timeline and serial CT/MRI panels of all patients be presented in acute brain insult cohorts? A pilot study of 45 patients with decompressive craniectomy after aneurysmal subarachnoid hemorrhage.Acta neurochirurgica · 2023Review
- Review
- Automated Quantification of Compartmental Blood Volumes Enables Prediction of Delayed Cerebral Ischemia and Outcomes After Aneurysmal Subarachnoid Hemorrhage.World neurosurgery · 2023Article
- Pathophysiology of Early Brain Injury and Its Association with Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage: A Review of Current Literature.Journal of clinical medicine · 2023Review
- Applying Quantitative Radiographic Image Markers to Predict Clinical Complications After Aneurysmal Subarachnoid Hemorrhage: A Pilot Study.Annals of biomedical engineering · 2022Article
- Increase in Brain Volume After Aneurysmal Subarachnoid Hemorrhage Leads to Unfavorable Outcome: A Retrospective Study Quantified by CT Scan.Frontiers in neurology · 2021Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
background and purposeEarly brain injury may be a more significant contributor to poor outcome after aneurysmal subarachnoid hemorrhage (aSAH) than vasospasm and delayed cerebral ischemia. However, studying this process has been hampered by lack of a means of quantifying the spectrum of injury. Global cerebral edema (GCE) is the most widely accepted manifestation of early brain injury but is currently assessed only through subjective, qualitative or semi-quantitative means. Selective sulcal volume (SSV), the CSF volume above the lateral ventricles, has been proposed as a quantitative biomarker of GCE, but is time-consuming to measure manually. Here we implement an automated algorithm to extract SSV and evaluate the age-dependent relationship of reduced SSV on early outcomes after aSAH.
methodsWe selected all adults with aSAH admitted to a single institution with imaging within 72 hours of ictus. Scans were assessed for qualitative presence of GCE. SSV was automatically segmented from serial CTs using a deep learning-based approach. Early SSV was the lowest SSV from all early scans. Modified Rankin Scale score of 4 to 6 at hospital discharge was classified as a poor outcome.
resultsTwo hundred forty-four patients with aSAH were included. Sixty-five (27%) had GCE on admission while 24 developed it subsequently within 72 hours. Median SSV on admission was 10.7 mL but frequently decreased, with minimum early SSV being 3.0 mL (interquartile range, 0.3-11.9). Early SSV below 5 mL was highly predictive of qualitative GCE (area under receiver-operating-characteristic curve, 0.90). Reduced early SSV was an independent predictor of poor outcome, with a stronger effect in younger patients.
conclusionsAutomated assessment of SSV provides an objective biomarker of GCE that can be leveraged to quantify early brain injury and dissect its impact on outcomes after aSAH. Such quantitative analysis suggests that GCE may be more impactful to younger patients with SAH.
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