CT Perfusion for the Detection of Delayed Cerebral Ischemia in the Presence of Neurologic Confounders

Excerpt

Delayed cerebral ischemia (DCI) is a common complication of aneurysmal subarachnoid hemorrhage (SAH), affecting up to 30% of patients and manifesting as new neurologic deficits or a declining level of consciousness, or both [1]. Timely identification and management of DCI are crucial to improving outcomes in patients with SAH [2]. However, diagnosing DCI remains challenging. Multiple confounders may present as worsening of the neurologic examination, potentially delaying recognition of underlying DCI. Moreover, confounders may hinder efforts to monitor the clinical response to a chosen therapy. Here, we present the case of a patient with SAH in whom the use of CT perfusion (CTP) scans was used to diagnose and subsequently manage DCI in the setting of multiple confounders. …