title: Normal high-resolution cerebral 99mTc-HMPAO SPECT scans in symptomatic neonates exposed to cocaine.
abstract: Vascular constriction is said to account for a variety of clinical effects of cocaine. High-resolution 99mTc-hexamethylpropylene amine oxime single photon emission computed tomographic (SPECT) scans, which measure cerebral blood flow, were used to determine whether neonatal brain perfusion deficits are present in newborns with confirmed cocaine exposure. Normal, age-appropriate SPECT scans were found in 21 babies. Conventional neuroimaging was also performed when possible. All but one of the 14 magnetic resonance imaging (MRI) scans and one computed tomographic scan were normal. One MRI showed a mild delay in myelination. All but four neonates had behavioral or electroencephalographic abnormalities, and microcephaly was found in five of 21. The normal neonatal SPECT scans contrast with findings in adult cocaine users, which typically report abnormal findings of cerebral hypoperfusion. This study identifies a unique lack of corresponding cerebral vascular pathology in symptomatic neonates. It raises the possibility that many of these children can escape significant ischemic injury.
authors.affiliation: Medical College of Wisconsin, Milwaukee.
authors.forename: R J
authors.initials: RJ
authors.lastname: Konkol
authors.forename: R S
authors.initials: RS
authors.lastname: Tikofsky
authors.forename: R
authors.initials: R
authors.lastname: Wells
authors.forename: R S
authors.initials: RS
authors.lastname: Hellman
authors.forename: P
authors.initials: P
authors.lastname: Nemeth
authors.forename: D J
authors.initials: DJ
authors.lastname: Walsh
authors.forename: R
authors.initials: R
authors.lastname: Heimler
authors.forename: J R
authors.initials: JR
authors.lastname: Sty
mesh_terms: D001921:Brain / Q000254:growth & development*; D002560:Cerebrovascular Circulation; D003042:Cocaine / Q000009:adverse effects*; D004569:Electroencephalography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn / Q000254:growth & development*; D009357:Neonatal Abstinence Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D015609:Organotechnetium Compounds; D010091:Oximes; D011247:Pregnancy; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D003042:Cocaine