The Usefulness of CT Brain Perfusion Image on Evaluation of Traumatic Brain Injury

Abstract

Objective: The purpose of this study is to evaluate the finding of computed tomography brain perfusion (CBP) in early traumatic brain injury patient. Methods: 33 patients with head trauma were evaluated and the patients were classified into 4 categories: traumatic subarachnoid hemorrhage (T-SAH), actue epidural hematoma (EDH), acutue subdural hematoma (SDH), traumatic intracerebral hemorrhage (T-ICH). We evaluated the cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) of the lesion vs contralateral lesion, lesion’s hemisphere and brain stem vs contralateral side and compared them. Results: T-SAH was found in 7 cases. And the all T-SAH patients have no perfusion defect and they have no ischemic change on follow up brain CT. EDH was found in 11 cases. 3 of the 11 EDH patients have perfusion defect that was not revealed by non-contrast CT. According to the EDH size, brain stem perfusion value was different. And at the same size of EDH, the value was low if patients have low initial GCS. SDH was found in 9 cases. The 2 cases have different operation. Decompressive craniectomy was made for one patient who have low perfusion value of brain stem. And osteoplastic craniotomy was made for the other patient who have relative high perfusion value. The low perfusion value of brain stem was correleated with brain swelling. T-ICH was found in 12 cases. Contusion sites have decreased perfusion value and the DTICH (delayed traumatic intracerebral hemorrhage) was developed perfusion defect area on initial CT brain perfusion. Conclusion: The CBP give us meaningful information of traumatic brain injury that associated with patient’s unexplained symptom, and may be useful for deciding operative plan, and predicting the prognosis of the patient. (J Kor Neurotraumatol Soc 2010;6:6-12)