Abstract WP53: The Assessment Of Brain Water Content At Posttraumatic Ischemia: Ct Perfusion Study

Abstract

Background: The influence of cerebral edema and secondary insults on the clinical outcome of traumatic brain injury (TBI) is well known. The studies of the brain water homeostasis dynamics at TBI remain rare, which determines the relevance of our work. The purpose is to study the changes in brain water homeostasis after TBI of varying severity compared to the cerebral microcirculation parameters. Materials: This non-randomized retrospective single-center study complies with the Helsinki Declaration. One hundred twenty-eight patients with posttraumatic ischemia (PCI) after moderate-to-severe TBI in the middle cerebral artery territory who presented between July 2015 and February 2022 to our hospital were included. PCI was determined using perfusion computed tomography (CT), and brain edema was determined using net water uptake (NWU) on baseline CT images. The patients were divided according to Marshall’s classification. Multivariate linear regression models were performed to analyze data. Results: NWU in PCI zones was significantly higher than in non-ischemic zones (8.1% versus 4.2%; P <0.001). In the multivariable regression analysis, the mean transit time increase was significantly and independently associated with higher NWU ( R 2 = 0,089, P <0.01). In the PCI zone, cerebral blood flow (CBF), volume (CBV), and time to peak (TTP) were not significantly associated with NWU values ( P >0.05). No significant differences existed between the NWU values in PCI foci in different Marshall groups ( P =0.308). Conclusion: The Marshall classification does not seem to be able to predict the progression of posttraumatic ischemia. The blood passage delay through the cerebral microvascular bed was significantly accompanied by brain tissue water uptake increase in the PCI focus.