Predictive value of brain perfusion single-photon emission computed tomography in acute ischemic stroke.
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.
Giubilei
F
F
Department of Neurological Sciences, University of Rome La Sapienza, Italy.
Lenzi
G L
GL
Di Piero
V
V
Pozzilli
C
C
Pantano
P
P
Bastianello
S
S
Argentino
C
C
Fieschi
C
C
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