Skip to main content

Brain MRI and SPET in thrombotic thrombocytopenic purpura

Abstract

We describe 5 cases of thrombotic thrombocytopenic purpura (TTP) with neurological manifestations. All of the patients underwent brain magnetic resonance imaging (MRI) following recovery; two underwent single photon emission tomography (SPET) during the acute phase of the disease. SPET showed reduced cerebral blood flow, whereas the results of brain MRI were normal in all patients. Plasma exchange (PE) treatment was promptly instituted in all cases.

Our findings show that prompt treatment with PE may avoid permanent brain damage even when the neurological signs and symptoms are relate to brain ischemia.

Sommario

Descriviamo 5 casi di Porpora Trombotica Trombocitopenica con manifestazioni neurologiche. Tutti i casi sono stati studiati mediante Risonanza Magnetica Cerebrale dopo la regressione della sintomatologia neurologica. Durante la fase acuta della malattia, due di loro sono stati studiati anche con SPET cerebrale. La SPET ha mostrato una riduzione del flusso ematico cerebrale mentre la Risonanza Magnetica è risultata normale in tutti i pazienti. Il trattamento con plasmaferesi veniva iniziato rapidamente in tutti i casi.

I nostri dati indicano che un repentino trattamento con plasmaferesi può evitare un danno neurologico permanente, sebbene i segni ed i sintomi siano ascrivibili all'ischemia cerebrale.

This is a preview of subscription content, access via your institution.

References

  1. Ben-Yehuda D., Rose M., Michaeli Y., Eldor A.:Permanent neurological complications in patients with thrombotic thrombocytopenic purpura. Amer. J. Hemat. 29:74–78, 1988.

    Google Scholar 

  2. Chosey M.S., Costa D.C., Iannotti I., Ell P., Crockard H.A.:99mTc-HMPAO SPET and cerebral blood flow: a study of CO 2 reactivity. Nucl. Med. Commun. 10:609–618, 1989.

    Google Scholar 

  3. D'Aprile P., Farchi G., Pagliarulo R., Carella A.:Thrombotic thrombocytopenic purpura: MR demonstration of reversible brain abnormalities. AJNR 15:19–20, 1994.

    Google Scholar 

  4. De la Sayette V.:Purpura Thrombotique Thrombocytopénique. I cas avec Imagerie par Résonance Magnétique. Rev. Neurol. 147 (4):314–317, 1991.

    Google Scholar 

  5. Kay A.C., Solberg Jr. L.A., Douglas A.N., Petitt R.M.:Prognostic significance of computed tomography of the brain in thrombotic thrombocytopenic purpura. Mayo Clin. Proc. 66 (6):602–607, 1991.

    Google Scholar 

  6. Silverstein A.:Thrombotic thrombocytopenic purpura. The initial neurologic manifestations. Arch. Neurol. 18:358–362, 1968.

    Google Scholar 

  7. Tardy B., Page Y., Convers P., Mismetti P., Barral F., Bertrand J.C.:Thrombotic thrombocytopenic purpura MR findings. AJNR 14:489–490, 1993.

    Google Scholar 

  8. Vianelli N., Catani L., Mattioli Belmonte M., Sermasi G., Cascione M.L., Gianni L. et al.:Ticlopidine in the treatment of thrombotic thrombocytopenic purpura: report of two cases. Hematologica 75:274–277, 1990.

    Google Scholar 

  9. Vianelli N., Sermasi G., D'Alessandro R., Zucchelli P., Belardinelli A.R., Catani L. et al.:Prompt plasma-exchange treatment and coma reversibility in two patients with thrombotic thrombocytopenic purpura. Haematologica 76:72–74, 1991.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Fiorani, L., Vianelli, N., Gugliotta, L. et al. Brain MRI and SPET in thrombotic thrombocytopenic purpura. Ital J Neuro Sci 16, 149–151 (1995). https://doi.org/10.1007/BF02282981

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02282981

Key Words

  • TTP
  • MRI
  • SPET
  • neurological manifestations