title: 99Tcm-HMPAO single photon emission tomography in the diagnosis of cerebral barotrauma.
abstract: Cerebral barotrauma, or the neurological manifestation of the "bends", is a relatively common disease of divers and aviators. To date, however, no-one has succeeded in demonstrating a cerebral or spinal cord lesion in vivo following a decompression incident, despite the presence of definitive clinical signs and symptoms of central nervous system involvement. This paper describes the use of 99Tcm-labelled hexamethylpropyleneamine oxime (99Tcm-HMPAO) with single photon emission tomography in a study of three individuals involved in driving accidents. All three suffered cerebral barotrauma during decompression and all exhibited clinical signs and symptoms of dysbarism to a varying degree. Imaging was performed at time intervals ranging from 2 h to several days following the incidents. The results showed well defined cerebral ischaemic lesions in all three subjects. We conclude that 99Tcm-HMPAO imaging provides a significant advance in locating and demonstrating cerebral lesions following barotrauma and will contribute greatly to our understanding of the pathophysiological processes involved.
authors.affiliation: Department of Nuclear Medicine, Royal Naval Hospital.
authors.forename: M A
authors.initials: MA
authors.lastname: Macleod
authors.forename: G H
authors.initials: GH
authors.lastname: Adkisson
authors.forename: M J
authors.initials: MJ
authors.lastname: Fox
authors.forename: R R
authors.initials: RR
authors.lastname: Pearson
mesh_terms: D000293:Adolescent; D000328:Adult; D001469:Barotrauma / Q000000981:diagnostic imaging*; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000000981:diagnostic imaging; D004618:Embolism, Air / Q000000981:diagnostic imaging; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging; D008297:Male; D009942:Organometallic Compounds; D010091:Oximes; D013667:Technetium; D019690:Technetium Tc 99m Exametazime; D014055:Tomography, Emission-Computed
chemical_list: D009942:Organometallic Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D013667:Technetium