title: Technetium-99m HM-PAO SPECT in patients with delayed neurologic sequelae after carbon monoxide poisoning.
abstract: We used single photon emission computed tomography (SPECT) with technetium-99m hexamethylpropylene amine oxime (99mTc-HM-PAO) in 14 studies on 6 patients with delayed neurologic sequelae from carbon monoxide (CO) poisoning to determine whether any changes in cerebral blood flow could be correlated with clinical or computed tomographic evidence of delayed deficits. Among the six initial CT brain scans, two showed low density of both basal ganglia and two showed decreased density of the cerebral white matter. There was no correlation between the clinical outcome and the findings of the follow-up CT brain scans. Of the two SPECTS with 99mTc-HM-PAO performed during acute anoxic insult, one showed focal hypoperfusion which appeared 20 days prior to the onset of delayed neurologic sequelae after CO poisoning. Seven SPECTs in the six patients performing the delayed phase showed diffuse patched patterns of hypoperfusion which improved on follow-up images. There was good correlation between the clinical outcome and the findings of the 99mTc-HM-PAO SPECT. In preliminary conclusion, 9Tc-HM-PAO brain SPECT can be used for predicting or evaluating the outcome of delayed neurologic sequelae after CO poisoning. Cerebral vascular changes may be the possible cause of hypoperfusion in patients with CO poisoning.
authors.affiliation: Department of Neurology, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: I S
authors.initials: IS
authors.lastname: Choi
authors.forename: M S
authors.initials: MS
authors.lastname: Lee
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lee
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.forename: S S
authors.initials: SS
authors.lastname: Lee
authors.forename: W T
authors.initials: WT
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D002249:Carbon Monoxide Poisoning / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011237:Predictive Value of Tests; D019690:Technetium Tc 99m Exametazime; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime