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Cerebral Net Water Uptake in Posttraumatic Cerebral Ischemia
Alex O Trofimov1, Kseniia A Trofimova1, Kyril Lidji-Goryaev1
1Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia.
Advances in Experimental Medicine and Biology
|October 16, 2023
Summary
Delayed cerebral blood flow in traumatic brain injury (TBI) patients is linked to increased net water uptake (NWU) in ischemic areas. Marshall
Area of Science:
- Neuroscience
- Radiology
- Critical Care Medicine
Background:
- Traumatic brain injury (TBI) can lead to posttraumatic ischemia, affecting cerebral microcirculation.
- Assessing changes in net water uptake (NWU) and mean transit time (MTT) is crucial for understanding TBI pathophysiology.
Purpose of the Study:
- To evaluate the relationship between net water uptake (NWU) and mean transit time (MTT) in posttraumatic ischemia zones in moderate-to-severe TBI patients.
- To investigate the predictive value of Marshall's classification for posttraumatic ischemia progression.
Main Methods:
- 128 moderate-to-severe TBI patients were stratified based on Marshall's classification.
- Multiphase perfusion computed tomography (PCT) was used to assess cerebral blood flow and mean transit time (MTT).
- Net water uptake (NWU) was calculated from non-contrast computed tomography scans.
Main Results:
- Net water uptake (NWU) was significantly higher in posttraumatic ischemia zones compared to unaffected areas (8.1% vs. 4.2%).
- A significant inverse correlation was found between mean transit time (MTT) and net water uptake (NWU) in ischemic regions.
- Cerebral blood flow was higher in Marshall 4 patients compared to Marshall 5 patients.
Conclusions:
- Delayed cerebral microvascular blood flow is significantly associated with increased net water uptake in posttraumatic ischemia foci.
- Marshall's classification system did not effectively predict the progression of posttraumatic ischemia in this cohort.
