glioma-related postoperative ischemia Stroke after brain tumor surgery
Conditions
Interventions
Three moments at which the patient will be scanned at the MRI 7T scanner with the use of the Respiract system (research instrument used to precisely control and monitor the levels of carbon dioxide (C
Sponsors
Universitair Medisch Centrum Utrecht
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: ? Suspected to have a high-grade glioma, for which surgical resection (=20% of enhancing tumour) is planned ? 18 years or older ? Karnofsky performance status of at least 70 during all timepoints? Ability to give written informed consent
Exclusion criteria
Exclusion criteria: ? History of vascular brain disease (stroke, moya-moya, aneurysm) ? Prior cerebral surgery or radiation ? Signs of obstructive hydrocephalus on diagnostic MRI or clinical indication of blockage of CSF outflow from the brain ? Symptoms of increased intracranial pressure (headache, nausea, blurred vision) even under dexamethasone ? Non-compliance with prescribed anti-seizure medication ? CNS haemorrhage of Grade > 1 on baseline MRI scan, unless subsequently documented to have resolved ? Any known metastatic extracranial or leptomeningeal disease ? Multifocal disease ? Pregnancy In addition, a potential subject who meets any of the following criteria prior to inclusion or any scan will be excluded from (further) participation in this study: ? Clinical signs of increased intracranial pressure even under dexamethasone ? Unwilling or unable to co-operate with breathing manoeuvres ? Respiratory or cardiac limitations to breathing at 20 L/min ? Medical contra-indications to limited hypercapnia (known metabolic acidosis or alkalosis) ? Standard contraindications for 7T MRI scanning, according to MRI guidelines.? Resting PetCO2 level is measured above 50 mmHg with the RespirAct before testing outside of the scanner.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The main endpoints will be CVR (%MRI signal change per change in mmHg end-tidal CO2) before and after surgery and 1 month after surgery. | — |
Secondary
| Measure | Time frame |
|---|---|
| The second endpoint: Relationship between alterations in CVR throughout the brain before surgery, after surgery, and at the recovery time-point directly preceding adjuvant treatment (generally 1 month post surgery) | — |
Countries
Netherlands
Contacts
Public ContactA Bhogal
Universitair Medisch Centrum Utrecht
Outcome results
None listed