Assessment of cerebral hemodynamics using computed tomography perfusion in patients with intracranial aneurysms

Abstract

Objective: to determine the impact of aneurysm of intracranial arteries on cerebral collateral circulation and to assess the relationship between these changes and the site of the aneurysm.Material and methods. CT perfusion and CT angiography were performed in 41 patients with 47 unruptured intracranial aneurysms of different sites and sizes.Results. Impaired perfusion was not found in the majority of the patients with intracranial aneurysms less than 15 mm in diameter. Hypoperfusion in the respective temporal and occipital lobes was noted in 70% of patients with aneurysms greater than 16–25 mm. Generalized hypoperfusion was diagnosed in 100% of patients with aneurysms more than 25 mm, with the partially thrombosed aneurysms accompanied by the severer, irreversible deficit immediately around the aneurysmal sac, which was induced by the effect of volumetric exposure while in the presence of unthrombosed aneurysm, hypoperfusion occasionally involved the cortex of the entire hemisphere. In this investigation, the extent and depth of hypoperfusion depended on the thrombosis of the lumen and the size of an aneurysm rather than the site of the latter.Conclusion. CT perfusion may be recommended as a standard examination of patients with detected intracranial aneurysm that is 16 mm or more in size for the timely diagnosis of cortical microcirculatory disorders and collateral circulatory insufficiency, which can affect the choice of a treatment option for the patient

Keywords

• computed tomography
• perfusion
• aneurysm
• hemodynamics
• angiography