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Ischemic lesions in acute and subacute perimesencephalic subarachnoid hemorrhage

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dc.contributor.authorFragata, Isabel
dc.contributor.authorCanto Moreira, Nuno
dc.contributor.authorCanhão, Patrícia
dc.date.accessioned2021-01-05T16:10:14Z
dc.date.available2021-01-05T16:10:14Z
dc.date.issued2019
dc.description© American Roentgen Ray Societypt_PT
dc.description.abstractObjective: Perimesencephalic hemorrhage (PMH) is a subtype of nonaneurysmal subarachnoid hemorrhage (SAH). In patients with aneurysmal SAH, the occurrence of acute ischemic lesions is associated with severity and poor outcome. We investigated the frequency of ischemic lesions on DWI in patients with PMH and compared it with the frequency of ischemic lesions in patients with aneurysmal SAH. Subjects and methods: From a prospective cohort of 80 patients with acute spontaneous SAH, we included 15 patients with PMH and 39 patients with aneurysmal SAH who were matched on the basis of their clinical condition (World Federation of Neurological Societies grade 1 or 2). MRI was performed less than 72 hours after SAH, 8-10 days after SAH, or at both points in time. The number and distribution of lesions previously seen on DWI that were also seen on a second MRI examination were assessed. Nonparametric tests were used to compare groups. Results: Early acute ischemic lesions (those identified < 72 hours after SAH) were found in 46.2% of patients with PMH and in 62.9% of patients with aneurysmal SAH. No significant differences in the number of acute ischemic lesions between groups were noted less than 72 hours after SAH (median, 0.5 lesion [interquartile range {IQR}, two lesions] in patients with PMH vs one lesion [IQR, three lesions] in patients with aneurysmal SAH [p = 0.48] or 8-10 days after SAH (median, 0.5 lesion [IQR, four lesions] in patients with PMH vs 1.5 lesions [IQR, three lesions] in patients with aneurysmal SAH [p = 0.26]). However, 58.3% of patients with aneurysmal SAH had new infarcts at 8-10 days, compared with 7.1% of patients with PMH. Patients with PMH had diffuse ischemic lesions, whereas patients with aneurysmal SAH in the anterior circulation had mainly supratentorial lesions. Conclusion: Early ischemic lesions appeared on DWI both in patients with PMH and in patients with aneurysmal SAH. The number of lesions increased during the time window for vasospasm, mainly in patients with aneurysmal SAH. Further studies are required to better understand the pathophysiologic mechanisms behind early ischemia in patients with PMH and their impact on prognosis.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAmerican Journal of Roentgenology. 2019;212: 418-424pt_PT
dc.identifier.doi10.2214/AJR.18.19700pt_PT
dc.identifier.eissn1546-3141
dc.identifier.issn0361-803X
dc.identifier.urihttp://hdl.handle.net/10451/45674
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAmerican Roentgen Ray Societypt_PT
dc.relation.publisherversionhttps://www.ajronline.org/pt_PT
dc.subjectDWIpt_PT
dc.subjectAneurysmal subarachnoid hemorrhagept_PT
dc.subjectIschemiapt_PT
dc.subjectPerimesencephalic hemorrhagept_PT
dc.titleIschemic lesions in acute and subacute perimesencephalic subarachnoid hemorrhagept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage424pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage418pt_PT
oaire.citation.titleAmerican Journal of Roentgenologypt_PT
oaire.citation.volume212pt_PT
person.familyNameCanhão
person.givenNamePatrícia
person.identifier.ciencia-id8F12-6A40-BE2E
person.identifier.orcid0000-0003-3816-0416
person.identifier.scopus-author-id6603685711
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicatione9d5a53f-d0d3-4cc4-9807-879ef76be505
relation.isAuthorOfPublication.latestForDiscoverye9d5a53f-d0d3-4cc4-9807-879ef76be505

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