Abstract
Cerebral vasospasm (CVS) occurs as a result of the breakdown in cerebral autoregulation mechanisms. Because cerebral vasospasm can occur after subrachnoid hemorrhage (SAH), it is important to evaluate borderline perfusion. Evaluation of borderline vascular insufficiency is important to reduce ischemic complications. In this study 25 patients with SAH were investigated by somatosensory evoked potentials (SEP), computed tomography (CT), digital subtraction angiography (DSA) and single photon emission computed tomography (SPECT) in order to predict borderline ischemic areas. Clinical grades were also correlated with these investigations. Thirteen patients had symptomatic vasospasm and 15 patients had angiographic vasospasm. SPECT showed hypoperfusion in 22 out of 25 patients. CT predicted CVS in 8 of these 22 patients. Our study shows that brain perfusion SPECT is a non-traumatic, non-invasive, non-allergic, inexpensive method for the prediction of cerebral vasospasm. We conclude that brain SPECT with Tc-99m HM-PAO is an accessible technique that can demonstrate varying degrees of regional tissue hypoperfusion in patients with delayed ischemic deficits due to CVS following SAH.
Similar content being viewed by others
References
Aaslid R, P Huber, H Nornes: Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound. J Neurosurg 60 (1984) 37–41
Andersen AR, H Friberg, NA Lassen, K Kristensen, RD Neirinck: Serial studies on cerebral blood flow using 99m Tc HM-PAO: a comparison with 133Xe. Nucl Med Comm 8 (1987) 549–557
Biller J, JC Godersky, HP Adams Jr: Management of aneurysmal subarachnoid hemorrhage. Curr Concepts Cerebrovasc Dis Stroke 23 (1988) 13–18
Buell U, H Stirner, H Braun, K Kreiten, A Ferbert: SPECT with 99 Tc m-HM PAO and 99 Tc M-pertechnetate to assess regional cerebral blood flow (rCBF) and blood volume (rCBV). Preliminary results in cerebrovascular disease and interictal epilepsy. Nuc Med Commun 8 (1987) 519–524
Cowan R, N Watson: Special characteristics and potential of single photon emission computed tomography in the brain. Seminars in Nuclear Medicine 10 (4) (1980) 335–344
Davis S, J Andrews, M Lichtenstein, A Kaye, B Tress, S Rossiter, N Salehi, D Binns: A Single-Photon Emission Computed Tomography Study of Hypoperfusion After Subarachnoid Hemarrhage. Stroke 21 (1990) 252–259
Hasan D, J Van Peski, I Loeve, EP Krenning, M Vermeulen: Single photon emission computed tomography in patients with acute hydrocephalus or with cerebral ischemia after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatr 54 (1991) 490–493
Heros RC, NT Zervas, V Varsos: Cerebral vasospasm after subarachnoid hemorrhage: An update. Ann Neurol 14 (1983) 599–608
Cerebral blood flow tomography with xenon-133. Seminare in Nuclear Medicine 15 (4) (1985) 347–356
Lear JL: Quantitative local cerebral blood flow measurement with technetium-99M HM-PAO; Evaluation using multiple radionuclide digital quantitative autoradiography. J Nucl Med 29 (1988) 1387–1392
Mani RL, RL Eisenberg: Complications of catheter cerebral arteriography: Analysis of 5000 procedures. II. Relation of complication rates to clinical and arteriographic diagnosis. AJR 131 (1978) 867–869
Matsuda H, S Higashi, I Asli: Evaluation of cerebral collateral circulation by Technetium-99M HM-PAO brain SPECT during Matas rest: Report of three cases. J Nuc Med 29 (1988) 1724–1729
Pertiest B, J Sichez, F Lille, P Hazeman, H Nakano, E Chaumier: Evaluation and prediction of the vasospasm severity following a ruptured supratentorial aneurysm from angiography, clinical grade and somatosensory evoked potentials. In: Auer LM (ed): Timing of aneurysm surgery. Walter de Gruyter, Berlin-New York 1985
Powers WJ, RL Grubb Jr, RP Baker, RP Baker, MA Mintun, ME Raichle: Regional cerebral blood flow and metabolism in reversible ischemia de to vasospasm. Determination by positron emission tomography. J Neurosurg 62 (1985) 539–546
Rawluk D, F Smith, H Deans, HG Gemmel, AF MacDonald: Technetium 99m HMPAO scanning in patients with subarachnoid hemorrhage: A preliminary study. The British journal of Radiology 61 (1988) 26–29
Raynaud C: Applying single photon emission computed tomography. In: Kuhl DE (ed): Principles of radionculide emission imaging. Pergamon press 1982
Royal H, T Hill, L Holman: Clinical brain imaging with isopropyl-iodamphetamine and SPECT. Seminare in Nuclear Medicine 15 (4) (1985) 357–376
Sano H, T Kanno, Y Shinomiya, K Katada, Y Katok, T Nakagawa, K Adachi: Prospection of chronic vasospasm by CT findings. Acta Neurochir 63 (1982) 23–30
Suzuki A, N Yasui, Z Ito: Brain dysfunction following vasospasm evaluated by somatosensory evoked potentials. Acta Neurochir 63 (1982) 53–58
Symon L, AD Wand, Costa E Silva, F Gentili: Perioperative used of somatosensory evoked responses in aneurysm surgery. J Neurosurg 60 (1984) 269–275
Yeh S, R Liu R, H Hu: Brain Spect imaging with 99Tc m-hexamethylpropyleneamine oxime in the early detection of cerebral infarction: comparison with transmission computed tomography. Nuclear medicine communications 7 (1986) 873–878
Yonas H, SK Wolfson Jr, D Gur, RE Latchaw, WF Good, H Leanza, DL Jackson, PJ Janetta, OM Reinmuth: Clinical experience with the use of xenon-enhanced CT blood flow mapping in cerebral vascular diseas. Stroke 15 (1984) 443–450
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Naderi, S., Özgüven, M.A., Bayhan, H. et al. Evaluation of cerebral vasospasm in patients with subarachnoid hemorrhage using single photon emission computed tomography. Neurosurg. Rev. 17, 261–265 (1994). https://doi.org/10.1007/BF00306813
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00306813