Ultrasound Perfusion Imaging After Aneurysmal Subarachnoid Hemorrhage

Asklepios Kliniken Hamburg GmbH30 enrolled

Overview

The purpose of this study is to examine wether delayed cerebral ischemia can be predicted by ultrasound brain perfusion imaging in patients with aneurysmal subarachnoid hemorrhage (SAH).

The delayed cerebral ischemia is a main complication in patient with aneurysmal subarachnoid hemorrhage which causes neurological deficit. So far there is no reliable diagnostic tool to predict the appearance of cerebral ischemia. The causal correlation between presence of cerebral vasospasm measured daily by transcranial Doppler sonography (TCD) and occurrence of cerebral ischemia detected by cranial computed tomography scan (CCT) is not finally verified. First studies demonstrated that ultrasound perfusion imaging (UPI) allows the detection of perfusion deficits in middle cerebral artery infarction. The purpose of our study is to evaluate the diagnostic and prognostic value of UPI to predict delayed cerebral ischemia. In our trial we compare parameters of UPI (b= rise rate, A= plateau of acoustic intensity) in patients with aneurysmal subarachnoid hemorrhage with results of follow-up cranial computed tomography scans (CCT), TCD results and clinical outcome.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Aneurysmal Subarachnoid Hemorrhage

Interventions

Ultrasound Perfusion ImagingDEVICE

Sonographic unit Phillips IU 22, 5ml SonoVue ultrasound contrast agent per examination, Duration: 1h

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aneurysmal subarachnoid hemorrhage, Hunt and Hess 0-5 * Informed consent * Sufficient transtemporal acoustic window * First examination within 48h after subarachnoid hemorrhage * Minimum Age 18 years Exclusion Criteria: * Contraindication against computed tomographic scan * Incompatibility against SonoVue™ * Acute respiratory distress syndrome * Uncontrollable hypertensive crisis * Severe pulmonary disease(pulmonary hypertension \> 90 mmHg) * acute severe cardiac insufficiency (New York Heart Association IV) * known right-left-shunt * pregnancy and breastfeeding * Substance dependence

Locations (1)

Department of Neurology, Asklepios Hospital North

Hamburg, Free and Hanseatic City of Hamburg, Germany

RECRUITING

Outcomes

Primary Outcomes

Change of perfusion

Detection of hypoperfusion (defined by 50% or more reduction in beta-value of comparing day 1. with day 5.) in one or more of four regions in one or both hemispheres before the detection of delayed ischemia after SAH in CCT.

Time frame: Baseline, Day 5

Secondary Outcomes

Correlation between perfusion parameters, clinical course and flow velocities

Correlation between perfusion parameters (beta- and A-value), clinical course (National Institute of Health Stroke Scale - NIHSS) and flow velocities in the middle and posterior cerebral artery from day 1 to day 90.

Time frame: Day 1 to 90

Change of Perfusion

Detection of hypoperfusion (defined by 50% or more reduction in A-value of comparing day 1. with day 5.) in one or more of four regions in one or both hemispheres before the detection of delayed ischemia after SAH in CCT.

Time frame: Baseline, Day 5

Central Contacts

Günter Seidel, MD, Professor of Neurology

CONTACT

0049(0)401818873076 g.seidel@asklepios.com

Data from ClinicalTrials.gov

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