title: Predictive value of brain perfusion single-photon emission computed tomography in acute ischemic stroke.
abstract: We investigated 32 patients with completed ischemic stroke less than or equal to 6 hours after the onset of symptoms by means of computed tomography, cerebral angiography, and technetium-99m-labeled hexamethylpropyleneamine oxime single-photon emission computed tomography to study cerebral blood flow. Follow-up computed tomography and cerebral blood flow studies were performed 1 week and 1 month after admission. Poor outcome at 1 month was evident in 18 (78%) of the 23 patients with severe neurologic deficit on admission and in 11 (92%) of the 12 patients with severe hypoperfusion in the affected hemisphere on admission. All 10 patients with severe impairment of both neurologic status and cerebral blood flow had a poor outcome at 1 month. We detected severe hypoperfusion in patients with large lesions on computed tomograms or cerebral artery occlusions on angiograms. Cerebral blood flow had increased at the 1-week follow-up despite different clinical outcomes. Our data provide evidence that early evaluation of cerebral blood flow with single-photon emission computed tomography is useful to detect subgroups of patients with different clinical outcomes during the acute phase of ischemic stroke.
authors.affiliation: Department of Neurological Sciences, University of Rome La Sapienza, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Giubilei
authors.forename: G L
authors.initials: GL
authors.lastname: Lenzi
authors.forename: V
authors.initials: V
authors.lastname: Di Piero
authors.forename: C
authors.initials: C
authors.lastname: Pozzilli
authors.forename: P
authors.initials: P
authors.lastname: Pantano
authors.forename: S
authors.initials: S
authors.lastname: Bastianello
authors.forename: C
authors.initials: C
authors.lastname: Argentino
authors.forename: C
authors.initials: C
authors.lastname: Fieschi
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011379:Prognosis; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon