Risk profile of patients with poor-grade aneurysmal subarachnoid hemorrhage using early perfusion computed tomography

Fon Yih Tsuang, Jo Yu Chen, Chung Wei Lee, Chien Hsun Li, Jing Er Lee, Dar Ming Lai, Fu Chang Hu, Yong Kwang Tu, Sung Tsang Hsieh, Kuo Chuan Wang

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17 Citations (Scopus)


Objective: To determine whether perfusion computed tomography (CT) is useful for identifying patients with poor-grade subarachnoid hemorrhage (SAH) with reversible etiologies and whether early obliteration in patients with poor-grade aneurysmal SAH leads to favorable outcomes. Methods: Patients with new-onset aneurysmal SAH in World Federation of Neurological Surgeons (WFNS) grade IV or V neurologic condition who had perfusion CT performed at admission were eligible for the study. The study retrospectively enrolled 38 patients seen between January 2007 and July 2009. The decision to perform an early obliteration was made by the family after a discussion with the neurosurgeons, neurointensivists, and interventional radiologists. The functional outcomes were correlated with the Glasgow Outcome Scale (GOS) at 6 months, and quantitative perfusion CT data were collected. Results: This study included 10 (26%) grade IV and 28 (74%) grade V patients. Favorable outcomes occurred in 19 (50%) patients, and 11 (29%) patients died. After a multivariate logistic regression analysis of the parameters, older age (odds ratio 1.104, P = 0.0317), bilateral prolonged mean transient time (MTT) at the thalami (odds ratio 4.155, P = 0.0362), and early obliteration (odds ratio 0.098, P = 0.003) were predictive of poor outcome. Conclusions: Early bilateral prolonged MTT at the thalami and old age are associated with a poor outcome. Early obliteration benefits a significant portion of SAH patients. Crown

Original languageEnglish
Pages (from-to)455-461
Number of pages7
JournalWorld Neurosurgery
Issue number5
Publication statusPublished - Nov 1 2012


  • Aneurysm
  • Perfusion computed tomography
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery


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