Role of whole-brain computed tomography perfusion in head injury patients to predict outcome

TS Bindu, Sameer Vyas, Niranjan Khandelwal, Vikas Bhatia, Sivashanmugam Dhandapani, Ajay Kumar, Chirag K Ahuja

Indian Journal of Radiology and Imaging 2017 27(3):268-273

Purpose: To evaluate utility, pattern, and extent of perfusion abnormalities in traumatic brain injury by using whole-brain computed tomography perfusion (CTP) and to assess co-relation of CTP data clinically with Glasgow outcome score (GOS). Materials and Methods: Prospective analytic evaluation of the traumatic head injury patients who were immediately taken up for CTP was done. Patient's demographic, clinical, and radiological findings were tabulated and analyzed. GOS was measured by a neurosurgeon after 3 months of trauma who was blinded to CTP results. Results: Of the 78 patients included in this study, 28 patients were found to have GOS 5, 19 of them had GOS 4, 27 of them had GOS 3, and 4 of them had a GOS 2. Higher mean cerebral blood flow (CBF) and cerebral blood volume (CBV) values were observed in those who had a better GOS, i.e., 4 or 5, whereas those in the GOS range ≤3 had lower mean CBF and CBV values. Conclusion: Statistically significant positive correlation was found between cerebral perfusion parameters with that of GOS. CBF of frontal area shows better correlation with GOS. CBF was the most important predictor among all the perfusion parameters.

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