Turkish Neurosurgery 2008 , Vol 18 , Num 1
Role of Diffusion-Weighted MRG in Predicting Outcome in Subarachnoid Hemorrhage Due to Anterior Communicating Artery Aneurysms
Abrar Ahad WANI1, RV PHADKE2, Sanjay BEHARI3, RN SAHU4, Awdesh JAISWAL5, VK JAIN6
11,3,4,5,6 Sanjay Gandhi Postgraduate Institute of Medical Sciences, Neurosurgery, UP, India
2Sanjay Gandhi Postgraduate Institute of Medical Sciences, Radiology, UP, India
AIM: Efficacy of DWI in detecting ischemic injury following anterior communicating artery aneurysmal SAH is studied

MATERIAL and METHODS: In this prospective study ,16 patients within 5 days of their ictus were included. Preoperative CT scan excluded an intracerebral infarct; an angiogram determined the extent of vasospasm; MR studies were done to detect cerebral ischemia and the diffusion coefficient (ADC) was calculated. Patients underwent surgery (n=12) or endovascular coiling (n=4). Postintervention CT scan within 24 hours and on day 5 determined radiological outcome as good or poor depending on the absence or presence of infarction. Clinical outcome at follow up (2-6 months) was regarded as good or poor when the patient was independent or dependent regarding daily activities, respectively,.

RESULTS: Restricted diffusion occurred in 8 (80%) of poor and in 1 (16.6%) of good grade patients (p<0.05). In patients with good radiological outcome (n=8), DWI restriction occurred in 2 (25%) patients. In patients with poor radiological outcome(n=8), DWI restriction occurred in 7 (87.5%) patients . At 2-6 month follow-up, 7 (77.8%) of 9 patients with restricted diffusion and 2 of 7 patients with no DWI abnormality showed a poor clinical outcome

CONCLUSION: Clinical and radiological outcome at follow-up is related to the preoperative DWI Keywords : Apparent diffusion, Radiological outcome, Subarachnoid hemorrhage

Corresponding author : Abrar Ahad Wanř, abrarwani@rediffmail.com