Reversible increased technetium-99m-HMPAO cerebral cortical activity: a scintigraphic reflection of luxuriant hyperperfusion.
A hemiparetic and aphasic patient, 3 days after acute traumatic transection of the left internal carotid artery requiring life-saving total embolic occlusion, revealed ipsilateral increased peripheral hemispheric 99mTc-HMPAO activity. Ten days postocclusion, HMPAO peripheral cortical flow normalized as hemiparesis and aphasia significantly cleared. The initial lateralized HMPAO hyperactivity pattern may reflect reactive hyperemia, a sign previously identified by contrast angiography and often associated with a better prognosis in evolving CVA. Evanescent peripheral cerebral hyperemia may represent beneficial cortical collateralization of the periinfarct area of a deeper lacunar (white matter) CVA.
Strashun
A
A
Department of Radiology, State University of New York, Health Science Center, Brooklyn 11203.
Dunn
E K
EK
Sarkar
S S
SS
Abel
W
W
Hotson
G
G
Sclafani
S
S
D001039:Aphasia, Broca / Q000209:etiology; D020212:Carotid Artery Injuries; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002540:Cerebral Cortex / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000628:therapy*
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime