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Vasospasm after subarachnoid hemorrhage: interest in diffusion-weighted MR imaging
S Condette-Auliac1, S Bracard, R Anxionnat
1Department of Diagnostic and Interventional Neuroradiology, CHU, Nancy, France.
Stroke
|August 4, 2001
Summary
Diffusion-weighted MRI (DWI) can detect silent ischemic lesions in patients with vasospasm after subarachnoid hemorrhage. DWI may predict lesion progression, aiding in patient management.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Subarachnoid hemorrhage (SAH) frequently causes vasospasm, leading to ischemic complications.
- Current diagnostic tools for vasospasm lack sensitivity in detecting parenchymal ischemia extent.
- Diffusion-weighted MRI (DWI) is highly sensitive for detecting cerebral ischemia in stroke.
Purpose of the Study:
- To evaluate if DWI can identify silent ischemic lesions in asymptomatic vasospasm patients post-SAH.
- To determine if DWI can predict the progression of ischemic lesions in vasospasm patients.
Main Methods:
- Seven asymptomatic vasospasm patients, 3 symptomatic vasospasm patients, and 4 non-vasospasm SAH patients were studied.
- Regular diffusion-weighted MRI (DWI) scans were performed.
- Apparent diffusion coefficients (ADCs) were calculated for all patients.
Main Results:
- All vasospasm patients, including asymptomatic ones, showed DWI abnormalities with reduced ADC, primarily in white matter.
- No abnormalities were found in patients without vasospasm.
- DWI abnormalities resolved completely in 4 patients; 3 showed residual focal ischemic lesions.
Conclusions:
- DWI abnormalities correlate with parenchymal involvement in asymptomatic vasospasm patients.
- Further research is needed to establish an ADC reversibility threshold for improved patient management.