title: [Contribution of 99m Tc-HMPAO single-photon emission-computed tomography to the perioperative evaluation of subarachnoid hemorrhage caused by ruptured aneurysms].
abstract: Twenty one cases of proven subarachnoid hemorrhage (S.A.H.) have been analysed in a protocol especially including transcranial doppler (T.C.D.) and 88mTc-H.M.P.A.O. single photon emission tomography (H.M.P.A.O.-S.P.E.C.T.). Seventeen patients were intraoperatively studied. All data were compared with clinical grading, computerized tomography (C.T.) and angiography. S.P.E.C.T. is a quite recent method of measuring and three-dimensional imaging of brain perfusion. It provides important information for the diagnosis of ischemic syndromes in S.A.H. Sixty-two S.P.E.C.T.-scans were performed in twenty one patients. Fifty-eight were abnormal and showed significant abnormalities of brain perfusion varying in extent and severity. In this preliminary study, we set out to validate the clinical use of H.M.P.A.O.-S.P.E.C.T. for the diagnosis of "vapospasm" comparing S.P.E.C.T. data with classical criteria. We propose a classification which allowed us to quantify the ischemic risk in an attempt to adapt the global therapeutic management to hemodynamic data. This method appears to be very sensitive and reliable in this field. It will introduce, if these first results are confirmed, important criteria for the evaluation of patients presenting with S.A.H. as far as prognosis and treatment are concerned, especially in regard to timing of surgery and institution of medical hemodynamic therapy.
authors.affiliation: Service de Neurochirurgie, Centre Gui de Chauliac, Montpellier.
authors.forename: P
authors.initials: P
authors.lastname: Coubes
authors.forename: F
authors.initials: F
authors.lastname: Segnarbieux
authors.forename: J
authors.initials: J
authors.lastname: Chevalier
authors.forename: M
authors.initials: M
authors.lastname: Deschamps
authors.forename: R
authors.initials: R
authors.lastname: Darmanaden
authors.forename: P O
authors.initials: PO
authors.lastname: Kotzki
authors.forename: F
authors.initials: F
authors.lastname: Barnay
authors.forename: P
authors.initials: P
authors.lastname: Frerebeau
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: J M
authors.initials: JM
authors.lastname: Blard
mesh_terms: D017542:Aneurysm, Ruptured / Q000150:complications*; D002560:Cerebrovascular Circulation; D004453:Echoencephalography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D007432:Intraoperative Period; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011184:Postoperative Period; D011300:Preoperative Care; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime
vernacular_title: Apport de la tomographie d'émission monophotonique par 99mTc-H.M.P.A.O. a l'évaluation hémodynamique périopératoire des hémorragies méningées par rupture d'anévrisme.