Abstract
Perfusion is thought to be impaired in brain edema due to reduced perfusion pressure. Brain edema therapy is assumed to improve perfusion. We assessed regional cerebral blood flow (rCBF)1 regional cerebral blood volume (rCBV) and mean transit time of blood (MIT) using perfusion-weighted magnetic resonance imaging (MRJ) in 75 patients showing acute local brain edema due to infarction or intracerebral hematoma. Patients were treated by intravenous infusion of 725 ml 40% sorbitol over 70 min. rCBFI rCBV and MIT in the edematous region were measured before and 30 min after treatment. Before treatment rCBF (46.5 ± 12.1 vs. 42.9 ± 10.5 ml 100 g-1 min-1)1 MIT (4.7 ± 1.9 vs. 4.0 ± 7.7 s) and rCBV (5.4 ± 1.7 vs. 4.7 ± 1.7 ml 100 g-1) were significantly (p < 0.05) increased in the edematous region compared to th contralateral side. After treatment no significant differences could be found. We interpret the elevation of MIT and rCBV in the edema as signs of an autoregulative compensation of an impaired perfusion. rCBF is even over-compensated. After brain edema therapy perfusion seems normalised. This new MRI method appears as useful for measuring therapeutic effects on cerebral perfusion. [Neural Res 1998; 20: 474-478]
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