Evaluation of cerebral hemodynamics by computed tomography perfusion imaging before and after cranioplasty in patients with brain injury.

OBJECTIVE: To assess the clinical significance of computed tomography perfusion (CTP) imaging by evaluating cerebral hemodynamic changes quantitatively and qualitatively both before and after cranioplasty in patients with brain injury.

METHODS: Sixteen patients with cerebral trauma underwent CTP imaging 2 days before and 10-15 days after cranioplasty. The cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time and time to peak were analysed in both the affected and corresponding contralateral regions, including the basal ganglia, thalamus, cortex and white matter. Quantitative analyses were performed before and after cranioplasty.

RESULTS: The CBF in the cortex of the affected side was significantly increased after cranioplasty (p < 0.05), while that in the white matter on the affected side was slightly lower than that on the contralateral side (p < 0.05). The CBV in the corresponding contralateral area of the basal ganglia decreased post-cranioplasty (p < 0.05). No other difference in blood flow parameters was found between the two sides before or after cranioplasty.

CONCLUSION: CTP imaging can accurately reflect changes in cerebral hemodynamics before and after cranioplasty in patients with trauma. Cranioplasty can significantly improve CBF in the cortex on the affected side for a short time (10-15 days) to meet the prevailing metabolic demand.