title: Evaluation of outcome of delayed neurologic sequelae after carbon monoxide poisoning by technetium-99m hexamethylpropylene amine oxime brain single photon emission computed tomography.
abstract: Using brain computed tomography (CT) and single photon emission computed tomography (SPECT) with technetium-99m hexamethylpropylene amine oxime (99mTc HM-PAO) in 13 patients with delayed neurologic sequelae after carbon monoxide poisoning, we tried to evaluate the clinical outcome of delayed CO sequelae. Among the 13 initial brain CTs, seven showed low density in the cerebral white matter and one revealed hypodensity in both globi pallidi. Of the 7 follow-up CT scans, 3 have remained unchanged, but in 4 cases more aggravating patterns with cortical atrophy without the clinical correlation were observed. There was no correlation between the CT findings and the outcome of delayed CO sequelae. All initial SPECTs in 13 patients with delayed CO sequelae showed diffuse patchy hypoperfusion throughout the cerebral cortex. Among the follow-up SPECTs in 7 patients, 6 patients showed increased cerebral perfusion with the concomitant clinical improvement, but the SPECT of a patient in bedridden state had remained unchanged, compared with the initial SPECT. There seemed to be good correlation between the findings of SPECT and the outcome of delayed CO sequelae. In conclusion, 99mTc HM-PAO brain SPECT is more sensitive than CT, and may be a useful test in evaluating the clinical outcome of delayed neurologic sequelae after CO poisoning.
authors.affiliation: Department of Neurology, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: I S
authors.initials: IS
authors.lastname: Choi
authors.forename: S K
authors.initials: SK
authors.lastname: Kim
authors.forename: S S
authors.initials: SS
authors.lastname: Lee
authors.forename: Y C
authors.initials: YC
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D001921:Brain / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping; D002249:Carbon Monoxide Poisoning / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002263:Carboxyhemoglobin / Q000378:metabolism; D002540:Cerebral Cortex / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D002534:Hypoxia, Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D002263:Carboxyhemoglobin