{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:03:28Z","timestamp":1762506208021},"reference-count":90,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Currently, perfusion CT (PCT) is a valuable imaging technique that has been successfully applied to the clinical management of patients with ischemic stroke and aneurysmal subarachnoid hemorrhage (SAH). However, recent literature and the authors' experience have shown that PCT has many more important clinical applications in a variety of neurosurgical conditions. Therefore, the authors share their experiences of its application in various diseases of the cerebrovascular, neurotraumatology, and neurooncology fields and review the pertinent literature regarding expanding PCT applications for neurosurgical conditions, including pitfalls and future developments.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A pertinent literature search was conducted of English-language articles describing original research, case series, and case reports from 1990 to 2011 involving PCT and with relevance and applicability to neurosurgical disorders.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>In the cerebrovascular field, PCT is already in use as a diagnostic tool for patients suspected of having an ischemic stroke. Perfusion CT can be used to identify and define the extent of the infarct core and ischemic penumbra core, and thus aid patient selection for acute reperfusion therapy. For patients with aneurysmal SAH, PCT provides assessment of early brain injury, cerebral ischemia, and infarction, in addition to vasospasm. It may also be used to aid case selection for aggressive treatment of patients with poor SAH grade. In terms of oncological applications, PCT can be used as an imaging biomarker to assess angiogenesis and response to antiangiogenetic treatments, differentiate between glioma grades, and distinguish recurrent tumor from radiation necrosis. In the setting of traumatic brain injury, PCT can detect and delineate contusions at an early stage. In patients with mild head injury, PCT results have been shown to correlate with the severity and duration of postconcussion syndrome. In patients with moderate or severe head injury, PCT results have been shown to correlate with patients' functional outcome.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Perfusion CT provides quantitative and qualitative data that can add diagnostic and prognostic value in a number of neurosurgical disorders, and also help with clinical decision making. With emerging new technical developments in PCT, such as characterization of blood-brain barrier permeability and whole-brain PCT, this technique is expected to provide more and more insight into the pathophysiology of many neurosurgical conditions.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.10.jns13103","type":"journal-article","created":{"date-parts":[[2013,11,22]],"date-time":"2013-11-22T15:03:24Z","timestamp":1385132604000},"page":"473-488","source":"Crossref","is-referenced-by-count":39,"title":["Clinical application of perfusion computed tomography in neurosurgery"],"prefix":"10.3171","volume":"120","author":[{"given":"Abel Po-Hao","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Neurosurgery,"},{"name":"Department of Surgery, National Taiwan University Hospital, Taipei;"},{"name":"Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin branch, Yun-Linp;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui-Chang","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery,"},{"name":"Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu-Ting","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery,"},{"name":"Department of Surgery, National Taiwan University Hospital, Taipei;"},{"name":"Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin branch, Yun-Linp;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Shiee","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Taiwan University Hospital, Taipei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Kai","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng-Jean","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery,"},{"name":"Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin branch, Yun-Linp;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chang-Hau Christian Hospital, Chang-Ha;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan-Shen","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery,"},{"name":"Department of Surgery, National Taiwan University Hospital, Taipei;"},{"name":"Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin branch, Yun-Linp;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao-Yu","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China Medical University, Bei-Gang Hospital, Yun-Lin, Taiwan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Wintermark","sequence":"additional","affiliation":[{"name":"Neuroradiology Division, Department of Radiology, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1996","DOI":"10.1161\/STROKEAHA.110.578997","article-title":"Endovascular treatment of acute ischemic stroke may be safely performed with no time window limit in appropriately selected patients","volume":"41","author":"Abou-Chebl","year":"2010"},{"key":"b2-jns13103","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1148\/radiol.2503080257","article-title":"Hemorrhagic transformation of ischemic stroke: prediction with CT perfusion","volume":"250","author":"Aviv","year":"2009"},{"key":"b3-jns13103","series-title":"Comput Med Imaging Graph","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/0895-6111(94)90023-X","article-title":"Functional perfusion and blood-brain barrier permeability images in the diagnosis of cerebral tumors by Angio CT","volume":"18","author":"Bartolini","year":"1994"},{"key":"b4-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1161\/01.STR.26.6.1086","article-title":"Cortical blood flow and cerebral perfusion pressure in a new noncraniotomy model of subarachnoid hemorrhage in the rat","volume":"26","author":"Bederson","year":"1995"},{"key":"b5-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2539","DOI":"10.1161\/STROKEAHA.110.591362","article-title":"Increased blood-brain barrier permeability on perfusion CT might predict malignant middle cerebral artery infarction","volume":"41","author":"Bektas","year":"2010"},{"key":"b6-jns13103","series-title":"Clin Cancer Res","first-page":"355","article-title":"Reduction of vascular and permeable regions in solid tumors detected by macromolecular contrast magnetic resonance imaging after treatment with antiangiogenic agent TNP-470","volume":"9","author":"Bhujwalla","year":"2003"},{"key":"b7-jns13103","series-title":"AJR Am J Roentgenol","doi-asserted-by":"publisher","first-page":"586","DOI":"10.2214\/AJR.06.1094","article-title":"Gadodiamide-associated nephrogenic systemic fibrosis: why radiologists should be concerned","volume":"188","author":"Broome","year":"2007"},{"key":"b8-jns13103","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1038\/sj.jcbfm.9600283","article-title":"Mechanisms of early brain injury after subarachnoid hemorrhage","volume":"26","author":"Cahill","year":"2006"},{"issue":"3 Suppl","key":"b9-jns13103","series-title":"Stroke","first-page":"S86","article-title":"Subarachnoid hemorrhage: is it time for a new direction?","volume":"40","author":"Cahill","year":"2009"},{"key":"b10-jns13103","series-title":"PLoS ONE","doi-asserted-by":"publisher","first-page":"e19886","DOI":"10.1371\/journal.pone.0019886","article-title":"The role of perfusion computed tomography in the prediction of cerebral hyperperfusion syndrome","volume":"6","author":"Chang","year":"2011"},{"key":"b11-jns13103","series-title":"Neurocrit Care","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1385\/NCC:3:3:216","article-title":"Neurological recovery after decompressive craniectomy for massive ischemic stroke","volume":"3","author":"Cheung","year":"2005"},{"key":"b12-jns13103","series-title":"J Neuroradiol","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/S0150-9861(06)77254-6","article-title":"Quantitative measurement of blood-brain barrier permeability using perfusion-CT in extra-axial brain tumors","volume":"33","author":"Cianfoni","year":"2006"},{"key":"b13-jns13103","series-title":"J Neurol","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1007\/s00415-008-0802-1","article-title":"Accuracy of perfusion-CT in predicting malignant middle cerebral artery brain infarction","volume":"255","author":"Dittrich","year":"2008"},{"key":"b14-jns13103","series-title":"Lancet Neurol","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/S1474-4422(09)70041-9","article-title":"Penumbral selection of patients for trials of acute stroke therapy","volume":"8","author":"Donnan","year":"2009"},{"key":"b15-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1981","DOI":"10.3174\/ajnr.A0688","article-title":"Role of perfusion CT in glioma grading and comparison with conventional MR imaging features","volume":"28","author":"Ellika","year":"2007"},{"key":"b16-jns13103","series-title":"Neurocrit Care","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/s12028-009-9243-7","article-title":"Diagnosing brain death by CT perfusion and multislice CT angiography","volume":"11","author":"Escudero","year":"2009"},{"key":"b17-jns13103","series-title":"Med Intensiva","first-page":"335","article-title":"[Diagnosis of brain death by multislice CT scan: angioCT scan and brain perfusion.]","volume":"31","author":"Escudero","year":"2007"},{"key":"b18-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1161\/STROKEAHA.111.616730","article-title":"Perfusion CT in patients with spontaneous lobar intracerebral hemorrhage: effect of surgery on perihemorrhagic perfusion","volume":"43","author":"Etminan","year":"2012"},{"key":"b19-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1161\/STROKEAHA.111.630954","article-title":"Angiographic reconstructions from whole-brain perfusion CT for the detection of large vessel occlusion in acute stroke","volume":"43","author":"Fr\u00f6lich","year":"2012"},{"key":"b20-jns13103","series-title":"AJNR Am J Neuroradiol","first-page":"1205","article-title":"CT perfusion parameter values in regions of diffusion abnormalities","volume":"25","author":"Galvez","year":"2004"},{"key":"b21-jns13103","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1159\/000096298","article-title":"Is there a penumbra surrounding intracerebral hemorrhage?","volume":"23","author":"Gass","year":"2007"},{"key":"b22-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3047","DOI":"10.1161\/STROKEAHA.111.615955","article-title":"Impact of extracranial-intracranial bypass on cerebrovascular reactivity and clinical outcome in patients with symptomatic moyamoya vasculopathy","volume":"42","author":"Han","year":"2011"},{"key":"b23-jns13103","series-title":"AJNR Am J Neuroradiol","first-page":"1095","article-title":"Relationship between brain tissue oxygen tension and CT perfusion: feasibility and initial results","volume":"26","author":"Hemphill","year":"2005"},{"key":"b24-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2941","DOI":"10.1161\/STROKEAHA.107.486977","article-title":"Evidence against a perihemorrhagic penumbra provided by perfusion computed tomography","volume":"38","author":"Herweh","year":"2007"},{"key":"b25-jns13103","series-title":"J Neuroimaging","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1111\/j.1552-6569.2009.00408.x","article-title":"Perfusion CT in hyperacute cerebral hemorrhage within 3 hours after symptom onset: is there an early perihemorrhagic penumbra?","volume":"20","author":"Herweh","year":"2010"},{"key":"b26-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.3174\/ajnr.A1257","article-title":"Renal safety of CT angiography and perfusion imaging in the emergency evaluation of acute stroke","volume":"29","author":"Hopyan","year":"2008"},{"key":"b27-jns13103","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1227\/NEU.0b013e3181ee359c","article-title":"Perfusion computed tomographic imaging and surgical selection with patients after poor-grade aneurysmal subarachnoid hemorrhage","volume":"67","author":"Huang","year":"2010"},{"key":"b28-jns13103","series-title":"J Trauma","first-page":"1578","article-title":"Intraoperative sonography for detection of contralateral acute epidural or subdural hematoma after decompressive surgery","volume":"70","author":"Huang","year":"2011"},{"key":"b29-jns13103","series-title":"J Trauma","first-page":"1593","article-title":"Early parenchymal contrast extravasation predicts subsequent hemorrhage progression, clinical deterioration, and need for surgery in patients with traumatic cerebral contusion","volume":"71","author":"Huang","year":"2011"},{"key":"b30-jns13103","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1159\/000228254","article-title":"Clinical significance of posterior circulation changes after revascularization in patients with moyamoya disease","volume":"28","author":"Huang","year":"2009"},{"key":"b31-jns13103","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"E1865","DOI":"10.1227\/NEU.0b013e3181f36022","article-title":"Progressive PCA steno-occlusive changes after revascularization for moyamoya disease: a neglected phenomenon","volume":"67","author":"Huang","year":"2010"},{"key":"b32-jns13103","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1089\/neu.2008.0625","article-title":"Decompressive craniectomy as the primary surgical intervention for hemorrhagic contusion","volume":"25","author":"Huang","year":"2008"},{"key":"b33-jns13103","series-title":"J Neurol","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s00415-009-5384-z","article-title":"Blood-brain barrier breakdown as a novel mechanism underlying cerebral hyperperfusion syndrome","volume":"257","author":"Ivens","year":"2010"},{"key":"b34-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.3174\/ajnr.A2263","article-title":"Perfusion CT imaging of brain tumors: an overview","volume":"32","author":"Jain","year":"2011"},{"key":"b35-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"388","DOI":"10.3174\/ajnr.A2280","article-title":"In vivo correlation of tumor blood volume and permeability with histologic and molecular angiogenic markers in gliomas","volume":"32","author":"Jain","year":"2011"},{"key":"b36-jns13103","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1159\/000306639","article-title":"Cerebral perfusion affects the risk of ischemia during carotid artery stenting","volume":"29","author":"Jongen","year":"2010"},{"key":"b37-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.3174\/ajnr.A1129","article-title":"Quantitative cerebrovascular reserve measured by acetazolamide-challenged dynamic CT perfusion in ischemic adult Moyamoya disease: initial experience with angiographic correlation","volume":"29","author":"Kang","year":"2008"},{"key":"b38-jns13103","series-title":"BMC Neurol","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1471-2377-10-80","article-title":"Case report of MR perfusion imaging in sinking skin flap syndrome: growing evidence for hemodynamic impairment","volume":"10","author":"Kemmling","year":"2010"},{"key":"b39-jns13103","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"523","DOI":"10.3109\/02688697.2011.578773","article-title":"Debate\u2014does a reversible penumbra exist in intracerebral haemorrhage?","volume":"25","author":"Kirkman","year":"2011"},{"key":"b40-jns13103","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1227\/01.NEU.0000338946.42939.C7","article-title":"Resuscitation and critical care of poor-grade subarachnoid hemorrhage","volume":"64","author":"Komotar","year":"2009"},{"key":"b41-jns13103","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.wneu.2011.12.080","article-title":"Decompressive hemicraniectomy, strokectomy, or both in the treatment of malignant middle cerebral artery syndrome","volume":"78","author":"Kostov","year":"2012"},{"key":"b42-jns13103","series-title":"AJNR Am J Neuroradiol","first-page":"419","article-title":"Quantitative cerebral blood flow measurement with dynamic perfusion CT using the vascular-pixel elimination method: comparison with H2(15)O positron emission tomography","volume":"24","author":"Kudo","year":"2003"},{"key":"b43-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2110","DOI":"10.1161\/hs0901.095692","article-title":"Long-term prognosis of medically treated patients with internal carotid or middle cerebral artery occlusion: can acetazolamide test predict it?","volume":"32","author":"Kuroda","year":"2001"},{"key":"b44-jns13103","series-title":"J Neuroradiol","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/S0150-9861(06)77237-6","article-title":"The role of spiral CT for the assessment of the intracranial circulation in suspected brain-death","volume":"33","author":"Leclerc","year":"2006"},{"key":"b45-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3552","DOI":"10.1161\/STROKEAHA.109.561274","article-title":"First Food and Drug Administration-approved prospective trial of primary intracranial stenting for acute stroke: SARIS (stent-assisted recanalization in acute ischemic stroke)","volume":"40","author":"Levy","year":"2009"},{"key":"b46-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.3174\/ajnr.A0539","article-title":"Measuring elevated microvascular permeability and predicting hemorrhagic transformation in acute ischemic stroke using first-pass dynamic perfusion CT imaging","volume":"28","author":"Lin","year":"2007"},{"key":"b47-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"721","DOI":"10.3174\/ajnr.A2365","article-title":"Quantitative measurement of cerebrovascular reactivity by blood oxygen level-dependent MR imaging in patients with intracranial stenosis: preoperative cerebrovascular reactivity predicts the effect of extracranial-intracranial bypass surgery","volume":"32","author":"Mandell","year":"2011"},{"key":"b48-jns13103","series-title":"J Am Coll Cardiol","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1016\/j.jacc.2003.12.016","article-title":"Magnetic resonance imaging and cardiac pacemaker safety at 1.5-Tesla","volume":"43","author":"Martin","year":"2004"},{"key":"b49-jns13103","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"2183","DOI":"10.1089\/neu.2010.1395","article-title":"Acute cerebral perfusion CT abnormalities associated with posttraumatic amnesia in mild head injury","volume":"27","author":"Metting","year":"2010"},{"key":"b50-jns13103","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1002\/ana.21785","article-title":"Perfusion computed tomography in the acute phase of mild head injury: regional dysfunction and prognostic value","volume":"66","author":"Metting","year":"2009"},{"key":"b51-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"154","DOI":"10.3174\/ajnr.A2715","article-title":"Applicability of tableside flat panel detector CT parenchymal cerebral blood volume measurement in neurovascular interventions: preliminary clinical experience","volume":"33","author":"Mordasini","year":"2012"},{"key":"b52-jns13103","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1212\/01.wnl.0000260621.86593.39","article-title":"CT angiography and CT perfusion in post-CEA hyperperfusion syndrome","volume":"68","author":"Muehlschlegel","year":"2007"},{"key":"b53-jns13103","series-title":"AJNR Am J Neuroradiol","first-page":"563","article-title":"Vascular reserve in chronic cerebral ischemia measured by the acetazolamide challenge test: comparison with positron emission tomography","volume":"16","author":"Nariai","year":"1995"},{"key":"b54-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1161\/01.STR.0000041048.33908.18","article-title":"Stages and thresholds of hemodynamic failure","volume":"34","author":"Nemoto","year":"2003"},{"key":"b55-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.1161\/01.STR.31.9.2175","article-title":"Prediction of malignant middle cerebral artery infarction by diffusion-weighted imaging","volume":"31","author":"Oppenheim","year":"2000"},{"key":"b56-jns13103","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1159\/000319026","article-title":"CT perfusion with angiography as a substitute for both conventional digital subtraction angiography and acetazolamide-challenged SPECT in the follow-up of postbypass patients","volume":"30","author":"Park","year":"2010"},{"key":"b57-jns13103","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1212\/01.wnl.0000256366.86353.ff","article-title":"Identification of the penumbra and infarct core on hyperacute noncontrast and perfusion CT","volume":"68","author":"Parsons","year":"2007"},{"key":"b58-jns13103","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"179","DOI":"10.3109\/02688690903536603","article-title":"Improved cerebrovascular reactivity following low flow EC\/IC bypass in patients with occlusive carotid disease","volume":"24","author":"Patel","year":"2010"},{"key":"b59-jns13103","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/jcbfm.1983.1","article-title":"Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data","volume":"3","author":"Patlak","year":"1983"},{"key":"b60-jns13103","series-title":"Neuropediatrics","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1055\/s-0030-1267209","article-title":"Usefulness of addition of CT perfusion to CT angiography for brain death diagnosis in a child","volume":"41","author":"Pell\u00f3n","year":"2010"},{"key":"b61-jns13103","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1212\/01.wnl.0000267641.08958.1b","article-title":"CT perfusion predicts secondary cerebral infarction after aneurysmal subarachnoid hemorrhage","volume":"69","author":"Pham","year":"2007"},{"key":"b62-jns13103","series-title":"AJR Am J Roentgenol","doi-asserted-by":"publisher","first-page":"763","DOI":"10.2214\/ajr.185.3.01850763","article-title":"The role of blood-brain barrier permeability in brain tumor imaging and therapeutics","volume":"185","author":"Provenzale","year":"2005"},{"key":"b63-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1658","DOI":"10.3174\/ajnr.A1229","article-title":"Which CT perfusion parameter best reflects cerebrovascular reserve?: correlation of acetazolamide-challenged CT perfusion with single-photon emission CT in Moyamoya patients","volume":"29","author":"Rim","year":"2008"},{"key":"b64-jns13103","series-title":"AJNR Am J Neuroradiol","first-page":"1077","article-title":"Multisection dynamic CT perfusion for acute cerebral ischemia: the \u201ctoggling-table\u201d technique","volume":"22","author":"Roberts","year":"2001"},{"key":"b65-jns13103","series-title":"Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1159\/000065681","article-title":"Dynamic single-section CT demonstrates reduced cerebral blood flow in acute intracerebral hemorrhage","volume":"14","author":"Rosand","year":"2002"},{"key":"b66-jns13103","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.clineuro.2005.03.012","article-title":"CT perfusion imaging in the syndrome of the sinking skin flap before and after cranioplasty","volume":"108","author":"Sakamoto","year":"2006"},{"key":"b67-jns13103","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s00701-005-0634-z","article-title":"CT perfusion imaging for childhood moyamoya disease before and after surgical revascularization","volume":"148","author":"Sakamoto","year":"2006"},{"key":"b68-jns13103","series-title":"Klin Neuroradiol","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s00062-009-9019-7","article-title":"Dynamic CT angiography and CT perfusion employing a 320-detector row CT: protocol and current clinical applications","volume":"19","author":"Salomon","year":"2009"},{"key":"b69-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"2047","DOI":"10.3174\/ajnr.A2693","article-title":"Using quantitative CT perfusion for evaluation of delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage","volume":"32","author":"Sanelli","year":"2011"},{"key":"b70-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1161\/STROKEAHA.109.568543","article-title":"Sinking skin flap syndrome and paradoxical herniation after hemicraniectomy for malignant hemispheric infarction","volume":"41","author":"Sarov","year":"2010"},{"key":"b71-jns13103","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1038\/jcbfm.2009.199","article-title":"Imaging of hypoxic-ischemic penumbra with (18)F-fluoromisonidazole PET\/CT and measurement of related cerebral metabolism in aneurysmal subarachnoid hemorrhage","volume":"30","author":"Sarrafzadeh","year":"2010"},{"key":"b72-jns13103","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1038\/jcbfm.2009.264","article-title":"Acute-stage diffusion-weighted magnetic resonance imaging for predicting outcome of poor-grade aneurysmal subarachnoid hemorrhage","volume":"30","author":"Sato","year":"2010"},{"key":"b73-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2986","DOI":"10.1161\/STROKEAHA.107.513358","article-title":"Quantitative assessment of core\/penumbra mismatch in acute stroke: CT and MR perfusion imaging are strongly correlated when sufficient brain volume is imaged","volume":"39","author":"Schaefer","year":"2008"},{"key":"b74-jns13103","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"722","DOI":"10.3171\/2009.9.JNS081255","article-title":"Intraoperative computed tomography angiography with computed tomography perfusion imaging in vascular neurosurgery: feasibility of a new concept. Clinical article","volume":"112","author":"Schichor","year":"2010"},{"key":"b75-jns13103","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s00234-011-0876-9","article-title":"CT angiography for evaluation of cerebral vasospasm following acute subarachnoid haemorrhage","volume":"54","author":"Shankar","year":"2012"},{"key":"b76-jns13103","series-title":"Nat Rev Neurol","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1038\/nrneurol.2010.74","article-title":"Blood-brain barrier breakdown as a therapeutic target in traumatic brain injury","volume":"6","author":"Shlosberg","year":"2010"},{"key":"b77-jns13103","series-title":"J Neuroradiol","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.neurad.2007.11.002","article-title":"Perfusion-CT assessment of the cerebrovascular reserve: a revisit to the acetazolamide challenges","volume":"35","author":"Smith","year":"2008"},{"key":"b78-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1161\/01.STR.0000170709.95185.b1","article-title":"Prediction of the clinical outcome of pediatric moyamoya disease with postoperative basal\/acetazolamide stress brain perfusion SPECT after revascularization surgery","volume":"36","author":"So","year":"2005"},{"key":"b79-jns13103","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s00234-007-0337-7","article-title":"Perfusion-CT for early assessment of traumatic cerebral contusions","volume":"50","author":"Soustiel","year":"2008"},{"key":"b80-jns13103","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1007\/978-3-211-85578-2_51","article-title":"Motor trephine syndrome: a mechanistic hypothesis","volume":"102","author":"Stiver","year":"2008"},{"key":"b81-jns13103","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"245","DOI":"10.3171\/JNS\/2008\/109\/8\/0245","article-title":"Reversible monoparesis following decompressive hemicraniectomy for traumatic brain injury","volume":"109","author":"Stiver","year":"2008"},{"key":"b82-jns13103","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"876","DOI":"10.3174\/ajnr.A1538","article-title":"The acetazolamide challenge: techniques and applications in the evaluation of chronic cerebral ischemia","volume":"30","author":"Vagal","year":"2009"},{"key":"b83-jns13103","series-title":"Lancet Neurol","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/S1474-4422(07)70036-4","article-title":"Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials","volume":"6","author":"Vahedi","year":"2007"},{"key":"b84-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1161\/01.STR.30.3.593","article-title":"Outcome of carotid artery occlusion is predicted by cerebrovascular reactivity","volume":"30","author":"Vernieri","year":"1999"},{"key":"b85-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1161\/STROKEAHA.108.542803","article-title":"Metabolic penumbra in intracerebral hemorrhage","volume":"40","author":"Vespa","year":"2009"},{"key":"b86-jns13103","series-title":"Crit Care Med","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1097\/01.CCM.0000130171.08842.72","article-title":"Relationship between brain perfusion computed tomography variables and cerebral perfusion pressure in severe head trauma patients","volume":"32","author":"Wintermark","year":"2004"},{"key":"b87-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2025","DOI":"10.1161\/01.STR.0000023579.61630.AC","article-title":"Comparison of admission perfusion computed tomography and qualitative diffusion- and perfusion-weighted magnetic resonance imaging in acute stroke patients","volume":"33","author":"Wintermark","year":"2002"},{"key":"b88-jns13103","series-title":"AJNR Am J Neuroradiol","first-page":"905","article-title":"Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study","volume":"22","author":"Wintermark","year":"2001"},{"key":"b89-jns13103","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1148\/radiol.2321030824","article-title":"Admission perfusion CT: prognostic value in patients with severe head trauma","volume":"232","author":"Wintermark","year":"2004"},{"key":"b90-jns13103","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3323","DOI":"10.1161\/STROKEAHA.110.608257","article-title":"Blood-brain barrier breakdown in acute and chronic cerebrovascular disease","volume":"42","author":"Yang","year":"2011"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/120\/2\/article-p473.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/120\/2\/article-p473.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/120\/2\/article-p473.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T13:58:47Z","timestamp":1658671127000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/120\/2\/article-p473.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2014,2]]},"references-count":90,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2013.10.jns13103","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2]]}}}