Indian Journal of Neurotrauma 2016; 13(01): 023-030
DOI: 10.1055/s-0036-1583265
Review Article

Perfusion Computed Tomography Study: A Utility Tool in Traumatic Cerebral Contusions

Vernon Velho
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Hrushikesh U. Kharosekar
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Shonali A. Valsangkar
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Jasmit Singh
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Pravin Survashe
1   Department of Neurosurgery, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
,
Sucheta Aher
2   Department of Radiology, Sir J. J. Group of Hospitals and Grant Medical College, Mumbai, Maharashtra, India
› Author Affiliations

Abstract

Aim To assess the usefulness of CT perfusion scans of the brain in patients with traumatic brain injury having cerebral contusion on CT scan.

Material and Methods This prospective study included 76 patients with cerebral contusion on plain CT of the brain, aged 5 to 86 years, admitted in our institution. They underwent perfusion CT as part of their admission CT survey and follow-up scan 48 hours later. Clinical data, unenhanced CT brain findings, and perfusion CT scans were evaluated with respect to the postoperative GCS (Glasgow Coma Score) and neurologic deficit.

Results Perfusion CT gave additional information when done with conventional unenhanced CT in the detection of cerebral contusions. Perfusion CT featured specific patterns with respect to patient outcome, patients with unfavorable outcome having significant decrease in cerebral perfusion. In patients having less GCS score, a significant decrease in cerebral blood flow and cerebral blood volume was detected.

Conclusion Perfusion CT provides independent useful information regarding functional outcome. In the acute phase of mild head injury, disturbed cerebral perfusion is seen in patients with normal noncontrast CT correlating with evolution, severity of injury, and outcome.



Publication History

Received: 11 June 2015

Accepted: 28 March 2016

Publication Date:
19 April 2016 (online)

© 2016. Thieme. All rights reserved.

Neurotrauma Society of India

 
  • References

  • 1 Gururaj G. Epidemiology of traumatic brain injuries: Indian scenario. Neurol Res 2002; 24 (01) 24-28
  • 2 Lee B, Newberg A. Neuroimaging in traumatic brain imaging. NeuroRx 2005; 2 (02) 372-383
  • 3 Metting Z, Rödiger LA, Stewart RE, Oudkerk M, De Keyser J, van der Naalt J. Perfusion computed tomography in the acute phase of mild head injury: regional dysfunction and prognostic value. Ann Neurol 2009; 66 (06) 809-816
  • 4 Wintermark M, van Melle G, Schnyder P. et al. Admission perfusion CT: prognostic value in patients with severe head trauma. Radiology 2004; 232 (01) 211-220
  • 5 Wintermark M, Soustiel J-F. Perfusion-CT: A non-invasive tool to monitor regional brain perfusion in traumatic brain injury patients and therapies impacting it. Open Neurosurg J 2010; 3: 59-63