Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage

TOPICS Preliminary study of CT perfusion of penumbra in patient with hypertensive intracranial haemorrhage INTRODUCTION Hypertension is a major illness in Malaysia with a prevalence of 24% (Zaher et al., 1998) and haemorrhagic stroke is its complications which much more likely to result in deat...

Full description

Saved in:

Bibliographic Details
Main Author:	Ghani, Zulkifli Zaki Abdul
Format:	Thesis
Language:	English
Published:	2006
Subjects:	R Medicine (General)
Online Access:	http://eprints.usm.my/47408/1/Preliminary%20Study%20Of%20CT%20Perfusion%20Of%20Penumbra%20In%20Patients%20With%20Hypertensive%20Intracranial%20Haemorrhage...2006...mka..-24%20pages.pdf
Tags:	Add Tag No Tags, Be the first to tag this record!

id	my-usm-ep.47408
record_format	uketd_dc
spelling	my-usm-ep.474082020-09-27T08:34:41Z Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage 2006 Ghani, Zulkifli Zaki Abdul R Medicine (General) TOPICS Preliminary study of CT perfusion of penumbra in patient with hypertensive intracranial haemorrhage INTRODUCTION Hypertension is a major illness in Malaysia with a prevalence of 24% (Zaher et al., 1998) and haemorrhagic stroke is its complications which much more likely to result in death or major disability than cerebral infarction(Broderick et al., 1993). Nonenhanced Computed Tomography (NECT) scan is the most common imaging modality used to diagnose intracranial haemorrhage (ICH). There were controversial issues whether medical or surgical treatment benefits these patients. CT perfusion (CTP) allowed the study of cerebral perfusion. TheoreticalJy it is useful in selecting for treatment option. Modified Barthel index (MBI) was a reliable disability scale (Suiter et al., 1999) and used as outcome assessment. OBJECTIVE This preliminary study was aimed to determine perfusion characteristics of perihaematoma region and correlation with clinical outcome. These will be used as predictor of the outcome whether medical or surgical treatment benefits the patients. This study also aimed to find contributing factors of abnormal perfusion in perihaematoma of hypertensive ICH and factors affecting its clinical outcome. MATERIAL AND METHOD From July 2004 till November 2005, I 0 patients were enrolled as they fulfilled the inclusion criteria and written informed consent obtained. NECT scan was done to confirm ICH then CTP was performed. The data were analyzed at the CT workstation. Haematoma volume and distance from skull were measured in NECT scan. Perihaematoma regions were divided into four sections in relation to distance from the skull. The regions of interest were drawn based on CTP colour mapping. Each parameters of perfusion were produced by the perfusion software and were analyzed whether selected region were normal, penumbra or umbra perfusion status. MBI was scored at presentation and 4 weeks. RESULT Significant statistical Spearman correlation at the 0.05 level (2-tailed) noted between ages and initial MBI, and haematoma volumes with haematoma distances to skull. Significant Pearson correlation of haematoma volume and ischaemic injury sizes at the 0.01 level (2- tailed) noted. Perfusion ischaemic injury were found in perihaematoma region however no statistical correlation of the perihaematoma area with clinical outcome. CONCLUSION CTP is a useful, easy and practical method in assessing intracranial perihaematoma perfusion however no correlation with clinical outcome. A bigger sample size may reverse these findings. 2006 Thesis http://eprints.usm.my/47408/ http://eprints.usm.my/47408/1/Preliminary%20Study%20Of%20CT%20Perfusion%20Of%20Penumbra%20In%20Patients%20With%20Hypertensive%20Intracranial%20Haemorrhage...2006...mka..-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Ghani, Zulkifli Zaki Abdul Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage
description	TOPICS Preliminary study of CT perfusion of penumbra in patient with hypertensive intracranial haemorrhage INTRODUCTION Hypertension is a major illness in Malaysia with a prevalence of 24% (Zaher et al., 1998) and haemorrhagic stroke is its complications which much more likely to result in death or major disability than cerebral infarction(Broderick et al., 1993). Nonenhanced Computed Tomography (NECT) scan is the most common imaging modality used to diagnose intracranial haemorrhage (ICH). There were controversial issues whether medical or surgical treatment benefits these patients. CT perfusion (CTP) allowed the study of cerebral perfusion. TheoreticalJy it is useful in selecting for treatment option. Modified Barthel index (MBI) was a reliable disability scale (Suiter et al., 1999) and used as outcome assessment. OBJECTIVE This preliminary study was aimed to determine perfusion characteristics of perihaematoma region and correlation with clinical outcome. These will be used as predictor of the outcome whether medical or surgical treatment benefits the patients. This study also aimed to find contributing factors of abnormal perfusion in perihaematoma of hypertensive ICH and factors affecting its clinical outcome. MATERIAL AND METHOD From July 2004 till November 2005, I 0 patients were enrolled as they fulfilled the inclusion criteria and written informed consent obtained. NECT scan was done to confirm ICH then CTP was performed. The data were analyzed at the CT workstation. Haematoma volume and distance from skull were measured in NECT scan. Perihaematoma regions were divided into four sections in relation to distance from the skull. The regions of interest were drawn based on CTP colour mapping. Each parameters of perfusion were produced by the perfusion software and were analyzed whether selected region were normal, penumbra or umbra perfusion status. MBI was scored at presentation and 4 weeks. RESULT Significant statistical Spearman correlation at the 0.05 level (2-tailed) noted between ages and initial MBI, and haematoma volumes with haematoma distances to skull. Significant Pearson correlation of haematoma volume and ischaemic injury sizes at the 0.01 level (2- tailed) noted. Perfusion ischaemic injury were found in perihaematoma region however no statistical correlation of the perihaematoma area with clinical outcome. CONCLUSION CTP is a useful, easy and practical method in assessing intracranial perihaematoma perfusion however no correlation with clinical outcome. A bigger sample size may reverse these findings.
format	Thesis
qualification_level	Master's degree
author	Ghani, Zulkifli Zaki Abdul
author_facet	Ghani, Zulkifli Zaki Abdul
author_sort	Ghani, Zulkifli Zaki Abdul
title	Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage
title_short	Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage
title_full	Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage
title_fullStr	Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage
title_full_unstemmed	Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage
title_sort	preliminary study of ct perfusion of penumbra in patients with hypertensive intracranial haemorrhage
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2006
url	http://eprints.usm.my/47408/1/Preliminary%20Study%20Of%20CT%20Perfusion%20Of%20Penumbra%20In%20Patients%20With%20Hypertensive%20Intracranial%20Haemorrhage...2006...mka..-24%20pages.pdf
_version_	1747821771372888064

Preliminary study of CT perfusion of penumbra in patients with hypertensive intracranial haemorrhage

Similar Items