Regional Cerebral Blood Flow in Peritumoral Brain Edema during Dexamethasone Treatment: A Xenon-enhanced Computed Tomographic Study

Regional Cerebral Blood Flow in Peritumoral Brain Edema during Dexamethasone Treatment: A... AbstractOBJECTIVERegional cerebral flood flow (rCBF) in peritumoral brain edema is assumed to be decreased because of increased interstitial pressure. Impaired blood flow might lead to local hypoxia, altered metabolism, and disturbed ion homeostasis, thus causing neurological sequelae. Steroid treatment is thought to positively influence the sequelae of brain edema. We aimed to determine the rCBF in peritumoral edema in humans receiving dexamethasone treatment and the relationship of rCBF to global CBF.METHODSWe measured rCBF in 11 patients with untreated anaplastic gliomas or glioblastomas that were World Health Organization Grade III or IV restricted to one hemisphere with significant peritumoral edema who were receiving a standard dose of dexamethasone. rCBF was determined using stable xenon-enhanced computed tomography in a stereotactic frame. Edema was defined both by means of actual histology (stereotactic biopsies) and by imaging criteria.RESULTSrCBF in peritumoral edema was decreased by 32% as compared with contralateral normal white matter. In each patient, this reduction was linearly related to blood flow in nonaffected white matter and cortex. The flow ratio in the different compartments was 1 (edema):1.5 (contralateral white matter):2.7 (contralateral cortex). Absolute perfusion values in contralateral cortex (means ± standard deviations) (29.9 ± 7.1 ml/100 g/min) and contralateral white matter (16.1 ± 3.7 ml/100 g/min) were significantly decreased as well.CONCLUSIONOur study demonstrated that rCBF in peritumoral brain edema during steroid treatment is still decreased and is in a range in which it may cause neurological sequelae. Also, global CBF was decreased in all patients. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Regional Cerebral Blood Flow in Peritumoral Brain Edema during Dexamethasone Treatment: A Xenon-enhanced Computed Tomographic Study

Regional Cerebral Blood Flow in Peritumoral Brain Edema during Dexamethasone Treatment: A Xenon-enhanced Computed Tomographic Study

Regional Cerebral Blood Flow in Peritumoral Brain Edema during Dexamethasone Treatment: A Xenon-enhanced Computed Tomographic Study Peter F. Behrens, M.D., Christoph B. Ostertag, M.D., Peter C. Warnke, M.D. Neurologische Universitatsklinik (PFB) and Abteilung Stereotaktische Neurochirurgie, Neurochirurgische Universitatsklinik (C B O , PCW), Freiburg, Germany OBJECTIVE: Regional cerebral flood flow (rCBF) in peritumoral brain edema is assumed to be decreased because of increased interstitial pressure. Impaired blood flow might lead to local hypoxia, altered metabolism, and disturbed ion homeostasis, thus causing neurological sequelae. Steroid treatment is thought to positively influ­ ence the sequelae of brain edema. We aimed to determine the rCBF in peritumoral edema in humans receiving dexamethasone treatment and the relationship of rCBF to global CBF. METHODS: We measured rCBF in 11 patients with untreated anaplastic gliomas or glioblastomas that were World Health Organization Grade III or IV restricted to one hemisphere with significant peritumoral edema who were receiving a standard dose of dexamethasone. rCBF was determined using stable xenon-enhanced computed tomography in a stereotactic frame. Edema was defined both by means of actual histology (stereotactic biopsies) and by imaging criteria. RESULTS: rCBF in peritumoral edema was decreased by 32% as compared with contralateral normal white matter. In each patient, this reduction was linearly related to blood flow in nonaffected white matter and cortex. The flow ratio in the different compartments was 1 (edema):1.5 (contralateral white matter):2.7 (contralateral cortex). Absolute perfusion values in contralateral cortex (means ± standard deviations) (29.9 ± 7.1 ml/100 g/min) and contralateral white matter (16.1 ± 3.7 ml/100 g/min) were significantly decreased as well. CO N CLU SIO N : O ur study demonstrated that rCBF in peritumoral brain edema during steroid treatment is still...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199808000-00027
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVERegional cerebral flood flow (rCBF) in peritumoral brain edema is assumed to be decreased because of increased interstitial pressure. Impaired blood flow might lead to local hypoxia, altered metabolism, and disturbed ion homeostasis, thus causing neurological sequelae. Steroid treatment is thought to positively influence the sequelae of brain edema. We aimed to determine the rCBF in peritumoral edema in humans receiving dexamethasone treatment and the relationship of rCBF to global CBF.METHODSWe measured rCBF in 11 patients with untreated anaplastic gliomas or glioblastomas that were World Health Organization Grade III or IV restricted to one hemisphere with significant peritumoral edema who were receiving a standard dose of dexamethasone. rCBF was determined using stable xenon-enhanced computed tomography in a stereotactic frame. Edema was defined both by means of actual histology (stereotactic biopsies) and by imaging criteria.RESULTSrCBF in peritumoral edema was decreased by 32% as compared with contralateral normal white matter. In each patient, this reduction was linearly related to blood flow in nonaffected white matter and cortex. The flow ratio in the different compartments was 1 (edema):1.5 (contralateral white matter):2.7 (contralateral cortex). Absolute perfusion values in contralateral cortex (means ± standard deviations) (29.9 ± 7.1 ml/100 g/min) and contralateral white matter (16.1 ± 3.7 ml/100 g/min) were significantly decreased as well.CONCLUSIONOur study demonstrated that rCBF in peritumoral brain edema during steroid treatment is still decreased and is in a range in which it may cause neurological sequelae. Also, global CBF was decreased in all patients.

Journal

NeurosurgeryOxford University Press

Published: Aug 1, 1998

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