Early and delayed blood-brain barrier permeability predicts delayed cerebral ischemia and outcomes following aneurysmal subarachnoid hemorrhage
Objectives This study aimed to monitor blood-brain barrier permeability within 24 h and during the delayed cerebral ischemia (DCI) time window (DCITW) spanning 4–14 days after aneurysmal subarachnoid hemorrhage (aSAH) and to investigate its correlation with both DCI occurrence and outcomes at three...
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| creator | Zhang, Chao Tang, Wenjuan Cheng, Liang Yang, Chen Wang, Ting Wang, Juan Miao, Zhuang Zhao, Xintong Fang, Xinggen Zhou, Yunfeng |
| description | Objectives
This study aimed to monitor blood-brain barrier permeability within 24 h and during the delayed cerebral ischemia (DCI) time window (DCITW) spanning 4–14 days after aneurysmal subarachnoid hemorrhage (aSAH) and to investigate its correlation with both DCI occurrence and outcomes at three months.
Methods
A total of 128 patients were stratified based on the DCI occurrence and three-month modified Rankin scale scores. Comparison of K
trans
at admission (admission K
trans
) and during DCITW (DCITW K
trans
) was conducted between DCI and non-DCI groups, as well as between groups with good and poor outcomes. Changes in K
trans
were also analyzed. Multivariate logistic regression analysis was performed to identify independent predictors of DCI and poor outcomes.
Results
Admission K
trans
(0.58 ± 0.18 vs 0.47 ± 0.12,
p
= 0.002) and DCITW K
trans
(0.54 ± 0.19 vs 0.41 ± 0.14,
p
< 0.001) were significantly higher in the DCI group compared with the non-DCI group. Although both were higher in the poor outcome group than the good outcome group, the difference was not statistically significant at admission (0.53 ± 0.18 vs 0.49 ± 0.14,
p
= 0.198). K
trans
in the non-DCI group (0.47 ± 0.12 vs 0.41 ± 0.14,
p
= 0.004) and good outcome group (0.49 ± 0.14 vs 0.41 ± 0.14,
p
< 0.001) decreased significantly from the admission to DCITW. Multivariate analysis identified DCITW K
trans
and admission K
trans
as independent predictors of poor outcomes (OR = 1.73, 95%CI: 1.24–2.43,
p
= 0.001) and DCI (OR = 1.75, 95%CI: 1.25–2.44,
p
= 0.001), respectively.
Conclusion
Elevated K
trans
at admission is associated with the occurrence of DCI. Continuous monitoring of K
trans
from admission to DCITW can accurately identify reversible and irreversible changes and can predict outcomes at 3 months.
Clinical relevance statement
K
trans
measured with CT perfusion is a valuable tool for predicting both delayed cerebral ischemia and three-month outcomes following aneurysmal subarachnoid hemorrhage. Monitoring changes in K
trans
from admission to time window of delayed cerebral ischemia can guide treatment and management decisions for aneurysmal subarachnoid hemorrhage patients.
Key Points
•
K
trans
measured at admission and during the delayed cerebral ischemia time window (4–14 days) holds distinct clinical significance following aneurysmal subarachnoid hemorrhage.
•
Admission K
trans
serves as a predictor for delayed cerebral ischemia, while continuous assessment of K
trans
from a |
| doi_str_mv | 10.1007/s00330-023-10571-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2914257193</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3081981359</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-64e10a32d342be5dadf473543277d21012fc2f14902bee0f2659de025b98df8e3</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhS0Eon-8AAtkiQ2bwNhObpIlqgpFqtRNu7aceHKvKye-jBNd5Sl4ZYbeUhALVv6Z7xyP5wjxVsFHBVB_ygDGQAHaFAqqWhWHF-JUlUbzsSlf_rU_EWc5PwBAq8r6tTgxjdaqauBU_LhyFFfpJi89Rreil11MyRcduTDJzhEFJLlHGtF1IYZ5lXtCH_o5Pyt6JGQ-ypD7HY7BPfqlZe7TiFkOKcZ0CNOWr3GhNY-M5oW9Xb-bUvCSRYlo57Z4IV4NLmZ887Sei_svV3eX18XN7ddvl59vit7ozVxsSlTgjPam1B1W3vmhrE3F_61rrxUoPfR6UGULXEYY9KZqPYKuurbxQ4PmXHw4-u4pfV8wz3bk5jFGbjEt2WqelOaZtobR9_-gD2mhibuzBhrVNspULVP6SPWUciYc7J7C6Gi1CuyvuOwxLstx2ce47IFF756sl25E_yz5nQ8D5ghkLk1bpD9v_8f2J59Oo1Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3081981359</pqid></control><display><type>article</type><title>Early and delayed blood-brain barrier permeability predicts delayed cerebral ischemia and outcomes following aneurysmal subarachnoid hemorrhage</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Zhang, Chao ; Tang, Wenjuan ; Cheng, Liang ; Yang, Chen ; Wang, Ting ; Wang, Juan ; Miao, Zhuang ; Zhao, Xintong ; Fang, Xinggen ; Zhou, Yunfeng</creator><creatorcontrib>Zhang, Chao ; Tang, Wenjuan ; Cheng, Liang ; Yang, Chen ; Wang, Ting ; Wang, Juan ; Miao, Zhuang ; Zhao, Xintong ; Fang, Xinggen ; Zhou, Yunfeng</creatorcontrib><description>Objectives
This study aimed to monitor blood-brain barrier permeability within 24 h and during the delayed cerebral ischemia (DCI) time window (DCITW) spanning 4–14 days after aneurysmal subarachnoid hemorrhage (aSAH) and to investigate its correlation with both DCI occurrence and outcomes at three months.
Methods
A total of 128 patients were stratified based on the DCI occurrence and three-month modified Rankin scale scores. Comparison of K
trans
at admission (admission K
trans
) and during DCITW (DCITW K
trans
) was conducted between DCI and non-DCI groups, as well as between groups with good and poor outcomes. Changes in K
trans
were also analyzed. Multivariate logistic regression analysis was performed to identify independent predictors of DCI and poor outcomes.
Results
Admission K
trans
(0.58 ± 0.18 vs 0.47 ± 0.12,
p
= 0.002) and DCITW K
trans
(0.54 ± 0.19 vs 0.41 ± 0.14,
p
< 0.001) were significantly higher in the DCI group compared with the non-DCI group. Although both were higher in the poor outcome group than the good outcome group, the difference was not statistically significant at admission (0.53 ± 0.18 vs 0.49 ± 0.14,
p
= 0.198). K
trans
in the non-DCI group (0.47 ± 0.12 vs 0.41 ± 0.14,
p
= 0.004) and good outcome group (0.49 ± 0.14 vs 0.41 ± 0.14,
p
< 0.001) decreased significantly from the admission to DCITW. Multivariate analysis identified DCITW K
trans
and admission K
trans
as independent predictors of poor outcomes (OR = 1.73, 95%CI: 1.24–2.43,
p
= 0.001) and DCI (OR = 1.75, 95%CI: 1.25–2.44,
p
= 0.001), respectively.
Conclusion
Elevated K
trans
at admission is associated with the occurrence of DCI. Continuous monitoring of K
trans
from admission to DCITW can accurately identify reversible and irreversible changes and can predict outcomes at 3 months.
Clinical relevance statement
K
trans
measured with CT perfusion is a valuable tool for predicting both delayed cerebral ischemia and three-month outcomes following aneurysmal subarachnoid hemorrhage. Monitoring changes in K
trans
from admission to time window of delayed cerebral ischemia can guide treatment and management decisions for aneurysmal subarachnoid hemorrhage patients.
Key Points
•
K
trans
measured at admission and during the delayed cerebral ischemia time window (4–14 days) holds distinct clinical significance following aneurysmal subarachnoid hemorrhage.
•
Admission K
trans
serves as a predictor for delayed cerebral ischemia, while continuous assessment of K
trans
from admission to the delayed cerebral ischemia time window can predict three-month outcomes.
•
Monitoring K
trans
at different stages improves instrumental in enhancing decision-making and treatment planning for patients with aneurysmal subarachnoid hemorrhage.</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-023-10571-w</identifier><identifier>PMID: 38221580</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aneurysm ; Blood-brain barrier ; Blood-Brain Barrier - diagnostic imaging ; Brain Ischemia - diagnostic imaging ; Brain Ischemia - etiology ; Decision making ; Diagnostic Radiology ; Female ; Hemorrhage ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Ischemia ; Male ; Medicine ; Medicine & Public Health ; Membrane permeability ; Middle Aged ; Monitoring ; Multivariate analysis ; Neuro ; Neuroradiology ; Patients ; Permeability ; Predictive Value of Tests ; Prognosis ; Radiology ; Regression analysis ; Retrospective Studies ; Statistical analysis ; Stroke ; Subarachnoid hemorrhage ; Subarachnoid Hemorrhage - complications ; Subarachnoid Hemorrhage - diagnostic imaging ; Telemedicine ; Time Factors ; Time measurement ; Ultrasound ; Windows (intervals)</subject><ispartof>European radiology, 2024-08, Vol.34 (8), p.5287-5296</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-64e10a32d342be5dadf473543277d21012fc2f14902bee0f2659de025b98df8e3</cites><orcidid>0000-0001-5260-3071</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-023-10571-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-023-10571-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38221580$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Chao</creatorcontrib><creatorcontrib>Tang, Wenjuan</creatorcontrib><creatorcontrib>Cheng, Liang</creatorcontrib><creatorcontrib>Yang, Chen</creatorcontrib><creatorcontrib>Wang, Ting</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Miao, Zhuang</creatorcontrib><creatorcontrib>Zhao, Xintong</creatorcontrib><creatorcontrib>Fang, Xinggen</creatorcontrib><creatorcontrib>Zhou, Yunfeng</creatorcontrib><title>Early and delayed blood-brain barrier permeability predicts delayed cerebral ischemia and outcomes following aneurysmal subarachnoid hemorrhage</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
This study aimed to monitor blood-brain barrier permeability within 24 h and during the delayed cerebral ischemia (DCI) time window (DCITW) spanning 4–14 days after aneurysmal subarachnoid hemorrhage (aSAH) and to investigate its correlation with both DCI occurrence and outcomes at three months.
Methods
A total of 128 patients were stratified based on the DCI occurrence and three-month modified Rankin scale scores. Comparison of K
trans
at admission (admission K
trans
) and during DCITW (DCITW K
trans
) was conducted between DCI and non-DCI groups, as well as between groups with good and poor outcomes. Changes in K
trans
were also analyzed. Multivariate logistic regression analysis was performed to identify independent predictors of DCI and poor outcomes.
Results
Admission K
trans
(0.58 ± 0.18 vs 0.47 ± 0.12,
p
= 0.002) and DCITW K
trans
(0.54 ± 0.19 vs 0.41 ± 0.14,
p
< 0.001) were significantly higher in the DCI group compared with the non-DCI group. Although both were higher in the poor outcome group than the good outcome group, the difference was not statistically significant at admission (0.53 ± 0.18 vs 0.49 ± 0.14,
p
= 0.198). K
trans
in the non-DCI group (0.47 ± 0.12 vs 0.41 ± 0.14,
p
= 0.004) and good outcome group (0.49 ± 0.14 vs 0.41 ± 0.14,
p
< 0.001) decreased significantly from the admission to DCITW. Multivariate analysis identified DCITW K
trans
and admission K
trans
as independent predictors of poor outcomes (OR = 1.73, 95%CI: 1.24–2.43,
p
= 0.001) and DCI (OR = 1.75, 95%CI: 1.25–2.44,
p
= 0.001), respectively.
Conclusion
Elevated K
trans
at admission is associated with the occurrence of DCI. Continuous monitoring of K
trans
from admission to DCITW can accurately identify reversible and irreversible changes and can predict outcomes at 3 months.
Clinical relevance statement
K
trans
measured with CT perfusion is a valuable tool for predicting both delayed cerebral ischemia and three-month outcomes following aneurysmal subarachnoid hemorrhage. Monitoring changes in K
trans
from admission to time window of delayed cerebral ischemia can guide treatment and management decisions for aneurysmal subarachnoid hemorrhage patients.
Key Points
•
K
trans
measured at admission and during the delayed cerebral ischemia time window (4–14 days) holds distinct clinical significance following aneurysmal subarachnoid hemorrhage.
•
Admission K
trans
serves as a predictor for delayed cerebral ischemia, while continuous assessment of K
trans
from admission to the delayed cerebral ischemia time window can predict three-month outcomes.
•
Monitoring K
trans
at different stages improves instrumental in enhancing decision-making and treatment planning for patients with aneurysmal subarachnoid hemorrhage.</description><subject>Adult</subject><subject>Aged</subject><subject>Aneurysm</subject><subject>Blood-brain barrier</subject><subject>Blood-Brain Barrier - diagnostic imaging</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Brain Ischemia - etiology</subject><subject>Decision making</subject><subject>Diagnostic Radiology</subject><subject>Female</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Membrane permeability</subject><subject>Middle Aged</subject><subject>Monitoring</subject><subject>Multivariate analysis</subject><subject>Neuro</subject><subject>Neuroradiology</subject><subject>Patients</subject><subject>Permeability</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Subarachnoid hemorrhage</subject><subject>Subarachnoid Hemorrhage - complications</subject><subject>Subarachnoid Hemorrhage - diagnostic imaging</subject><subject>Telemedicine</subject><subject>Time Factors</subject><subject>Time measurement</subject><subject>Ultrasound</subject><subject>Windows (intervals)</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS0Eon-8AAtkiQ2bwNhObpIlqgpFqtRNu7aceHKvKye-jBNd5Sl4ZYbeUhALVv6Z7xyP5wjxVsFHBVB_ygDGQAHaFAqqWhWHF-JUlUbzsSlf_rU_EWc5PwBAq8r6tTgxjdaqauBU_LhyFFfpJi89Rreil11MyRcduTDJzhEFJLlHGtF1IYZ5lXtCH_o5Pyt6JGQ-ypD7HY7BPfqlZe7TiFkOKcZ0CNOWr3GhNY-M5oW9Xb-bUvCSRYlo57Z4IV4NLmZ887Sei_svV3eX18XN7ddvl59vit7ozVxsSlTgjPam1B1W3vmhrE3F_61rrxUoPfR6UGULXEYY9KZqPYKuurbxQ4PmXHw4-u4pfV8wz3bk5jFGbjEt2WqelOaZtobR9_-gD2mhibuzBhrVNspULVP6SPWUciYc7J7C6Gi1CuyvuOwxLstx2ce47IFF756sl25E_yz5nQ8D5ghkLk1bpD9v_8f2J59Oo1Q</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Zhang, Chao</creator><creator>Tang, Wenjuan</creator><creator>Cheng, Liang</creator><creator>Yang, Chen</creator><creator>Wang, Ting</creator><creator>Wang, Juan</creator><creator>Miao, Zhuang</creator><creator>Zhao, Xintong</creator><creator>Fang, Xinggen</creator><creator>Zhou, Yunfeng</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5260-3071</orcidid></search><sort><creationdate>202408</creationdate><title>Early and delayed blood-brain barrier permeability predicts delayed cerebral ischemia and outcomes following aneurysmal subarachnoid hemorrhage</title><author>Zhang, Chao ; Tang, Wenjuan ; Cheng, Liang ; Yang, Chen ; Wang, Ting ; Wang, Juan ; Miao, Zhuang ; Zhao, Xintong ; Fang, Xinggen ; Zhou, Yunfeng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-64e10a32d342be5dadf473543277d21012fc2f14902bee0f2659de025b98df8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aneurysm</topic><topic>Blood-brain barrier</topic><topic>Blood-Brain Barrier - diagnostic imaging</topic><topic>Brain Ischemia - diagnostic imaging</topic><topic>Brain Ischemia - etiology</topic><topic>Decision making</topic><topic>Diagnostic Radiology</topic><topic>Female</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Ischemia</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Membrane permeability</topic><topic>Middle Aged</topic><topic>Monitoring</topic><topic>Multivariate analysis</topic><topic>Neuro</topic><topic>Neuroradiology</topic><topic>Patients</topic><topic>Permeability</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Subarachnoid hemorrhage</topic><topic>Subarachnoid Hemorrhage - complications</topic><topic>Subarachnoid Hemorrhage - diagnostic imaging</topic><topic>Telemedicine</topic><topic>Time Factors</topic><topic>Time measurement</topic><topic>Ultrasound</topic><topic>Windows (intervals)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Chao</creatorcontrib><creatorcontrib>Tang, Wenjuan</creatorcontrib><creatorcontrib>Cheng, Liang</creatorcontrib><creatorcontrib>Yang, Chen</creatorcontrib><creatorcontrib>Wang, Ting</creatorcontrib><creatorcontrib>Wang, Juan</creatorcontrib><creatorcontrib>Miao, Zhuang</creatorcontrib><creatorcontrib>Zhao, Xintong</creatorcontrib><creatorcontrib>Fang, Xinggen</creatorcontrib><creatorcontrib>Zhou, Yunfeng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Chao</au><au>Tang, Wenjuan</au><au>Cheng, Liang</au><au>Yang, Chen</au><au>Wang, Ting</au><au>Wang, Juan</au><au>Miao, Zhuang</au><au>Zhao, Xintong</au><au>Fang, Xinggen</au><au>Zhou, Yunfeng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early and delayed blood-brain barrier permeability predicts delayed cerebral ischemia and outcomes following aneurysmal subarachnoid hemorrhage</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2024-08</date><risdate>2024</risdate><volume>34</volume><issue>8</issue><spage>5287</spage><epage>5296</epage><pages>5287-5296</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
This study aimed to monitor blood-brain barrier permeability within 24 h and during the delayed cerebral ischemia (DCI) time window (DCITW) spanning 4–14 days after aneurysmal subarachnoid hemorrhage (aSAH) and to investigate its correlation with both DCI occurrence and outcomes at three months.
Methods
A total of 128 patients were stratified based on the DCI occurrence and three-month modified Rankin scale scores. Comparison of K
trans
at admission (admission K
trans
) and during DCITW (DCITW K
trans
) was conducted between DCI and non-DCI groups, as well as between groups with good and poor outcomes. Changes in K
trans
were also analyzed. Multivariate logistic regression analysis was performed to identify independent predictors of DCI and poor outcomes.
Results
Admission K
trans
(0.58 ± 0.18 vs 0.47 ± 0.12,
p
= 0.002) and DCITW K
trans
(0.54 ± 0.19 vs 0.41 ± 0.14,
p
< 0.001) were significantly higher in the DCI group compared with the non-DCI group. Although both were higher in the poor outcome group than the good outcome group, the difference was not statistically significant at admission (0.53 ± 0.18 vs 0.49 ± 0.14,
p
= 0.198). K
trans
in the non-DCI group (0.47 ± 0.12 vs 0.41 ± 0.14,
p
= 0.004) and good outcome group (0.49 ± 0.14 vs 0.41 ± 0.14,
p
< 0.001) decreased significantly from the admission to DCITW. Multivariate analysis identified DCITW K
trans
and admission K
trans
as independent predictors of poor outcomes (OR = 1.73, 95%CI: 1.24–2.43,
p
= 0.001) and DCI (OR = 1.75, 95%CI: 1.25–2.44,
p
= 0.001), respectively.
Conclusion
Elevated K
trans
at admission is associated with the occurrence of DCI. Continuous monitoring of K
trans
from admission to DCITW can accurately identify reversible and irreversible changes and can predict outcomes at 3 months.
Clinical relevance statement
K
trans
measured with CT perfusion is a valuable tool for predicting both delayed cerebral ischemia and three-month outcomes following aneurysmal subarachnoid hemorrhage. Monitoring changes in K
trans
from admission to time window of delayed cerebral ischemia can guide treatment and management decisions for aneurysmal subarachnoid hemorrhage patients.
Key Points
•
K
trans
measured at admission and during the delayed cerebral ischemia time window (4–14 days) holds distinct clinical significance following aneurysmal subarachnoid hemorrhage.
•
Admission K
trans
serves as a predictor for delayed cerebral ischemia, while continuous assessment of K
trans
from admission to the delayed cerebral ischemia time window can predict three-month outcomes.
•
Monitoring K
trans
at different stages improves instrumental in enhancing decision-making and treatment planning for patients with aneurysmal subarachnoid hemorrhage.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38221580</pmid><doi>10.1007/s00330-023-10571-w</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5260-3071</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1084 |
| ispartof | European radiology, 2024-08, Vol.34 (8), p.5287-5296 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2914257193 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aneurysm Blood-brain barrier Blood-Brain Barrier - diagnostic imaging Brain Ischemia - diagnostic imaging Brain Ischemia - etiology Decision making Diagnostic Radiology Female Hemorrhage Humans Imaging Internal Medicine Interventional Radiology Ischemia Male Medicine Medicine & Public Health Membrane permeability Middle Aged Monitoring Multivariate analysis Neuro Neuroradiology Patients Permeability Predictive Value of Tests Prognosis Radiology Regression analysis Retrospective Studies Statistical analysis Stroke Subarachnoid hemorrhage Subarachnoid Hemorrhage - complications Subarachnoid Hemorrhage - diagnostic imaging Telemedicine Time Factors Time measurement Ultrasound Windows (intervals) |
| title | Early and delayed blood-brain barrier permeability predicts delayed cerebral ischemia and outcomes following aneurysmal subarachnoid hemorrhage |
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