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Completed

NCT Number: NCT03214705

Role of CT Perfusion in Predicting Poor Outcome After Subarachnoid Hemorrhage

Prospective evaluation of patients with subarachnoid hemorrhage (SAH) will be done by computed tomography angiography (CTA) and perfusion imaging (CTP) for any correlation between degree of vasospasm and perfusion deficit as well as evaluating the ability of CTP to predict delayed cerebral ischemia.

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Key information

Conditions

Subarachnoid Hemorrhage Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebral Vasospasm Cerebrovascular Disorders Delayed Cerebral Ischemia Hemorrhage Intracranial Hemorrhages Nervous System Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Vascular Diseases Vasospasm, Intracranial

Sex eligibility

All sexes

Study type

Observational

Primary location

Mohamed Abdel-Tawab Mohamed

Asyut, 71511, Egypt

About this study

Cerebral vasospasm is a serious complication of subarachnoid haemorrhage . In the first 2 weeks of SAH, angiographic vasospasm is seen up to 40-70% of patients and causes ischemic deficits in 15-36% of patients.

The best clinical indicator of significantly reduced brain perfusion (cerebral blood flow (CBF)<20 ml per 100 g/min) is the presence of new neurologic deficits. However, clinical symptoms may be vague and mimic other conditions in patients with SAH.

CT Perfusion can be used in the evaluation of patients with possible vasospasm after subarachnoid hemorrhage (SAH). It can thus be used to assess cerebral ischemia and infarction as a result of vasospasm after SAH.

The presence of cerebral vasospasm identified with transcranial Doppler, digital subtraction angiography, or CT angiography (CTA) is frequently used to confirm DCI. Presence of vasospasm, however, does not prove the presence of ischemia and absence of vasospasm does not rule out. Better diagnostic tests in the acute stage of deterioration, possibly caused by DCI, are therefore needed. In patients with SAH, CTP has recently been shown to be promising for detection of early ischemia.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • All patients presented with subarachnoid haemorrhage

Exclusion criteria

  • Patients with abnormal renal functions with creatinine ≥ 2 mg/dl/
  • Patients with hypersensitivity to contrast media.
  • Contraindication to radiation as pregnancy.

Treatment and study plan

Primary outcomes

  1. Cerebral blood flow (CBF) on Admission

    Time frame: 3 days from the attack

    Cerebral blood flow (CBF) on Admission in units of ml/100 gram brain tissue/ minute.

    The measurements will be compared with the outcome of the patient (namely monitoring delayed cerebral ischemia in SAH patients) to test if early CT perfusion could predict the poor outcome in SAH patients.

  2. Cerebral blood volume (CBV) on Admission

    Time frame: 3 days from the attack

    Cerebral blood volume (CBF) on Admission in units of ml/100 gram brain tissue.

  3. Mean transit time (MTT) on Admission

    Time frame: 3 days from the attack

    Mean transit time (MTT) on Admission in units of seconds.

Secondary outcomes

  1. Correlation of vasospasm to perfusion abnormality using Comparing between CT angiography and CT perfusion in patients with subarachnoid hemorrhage

    Time frame: 4-14 days from the attack

    Evaluating results of CT angiography and CT perfusion in patients for Correlating vasospasm and perfusion abnormality. Results will be dichotomous; positive and negative, then tested by cross tabulation.

  2. Hunt and Hess scale

    Time frame: 3 days from the attack

    Hunt and Hess clinical scale was performed for every patient.

    Grades are as the following:

    Grade 1: Asymptomatic or mild headache Grade 2: Cranial nerve palsy or moderate to severe headache/nuchal rigidity Grade 3: Mild focal deficit, lethargy, or confusion Grade 4: Stupor and/or hemiparesis Grade 5: Deep coma, decerebrate posturing, moribund appearance

  3. Fisher scale

    Time frame: 3 days from the attack

    Fisher scale quantifies the amount of SAH as the following:

    • None evident
    • Less than 1 mm thick
    • More than 1 mm thick
    • Diffuse or none with intraventricular hemorrhage or parenchymal extension

Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

Role of Computed Tomography Perfusion in Detection of Patients at Risk for Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

Important dates

Study start
2016
Primary completion
2018
Study completion
2018
First posted
Jul 11, 2017
Registry last updated
Sep 16, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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