Regional cerebral blood flow scintigraphy in tick-borne encephalitis and other aseptic meningoencephalitis.
In a prospective study, regional cerebral blood flow (rCBF) was studied in patients with aseptic meningoencephalitis at 6 wk and 1 yr after onset of disease.


METHODS
Patients with tick-borne encephalitis ([TBE] n = 73) and meningoencephalitis of other etiology ([non-TBE] n = 56) were investigated with rCBF-scintigraphy (SPECT). SPECT images in the acute phase of disease and at long-term follow-up were analyzed for blood-flow disturbances and their localization in the central nervous system and were correlated to clinical course and outcome.


RESULTS
Decreased rCBF was seen in 50% of patients after 6 wk (TBE 49%, non-TBE 50%) and in 46% (TBE 47%, non-TBE 46%) after 1 yr. The decrease in rCBF was moderate in 18% and 11% at 6 wk and in 8% and 9% at the 1-yr follow-up of TBE and non-TBE patients, respectively. Reduced rCBF was significantly more common among patients with encephalitis than among those with meningitis, and more common in males. The distribution of cerebral flow changes was predominantly patchy or multifocal. At long-term follow-up, improvement in rCBF was seen in 28 of 109 patients (26%), but worsening of decreased rCBF was demonstrated in 19 of 109 (17%). In TBE patients, remaining neurological symptoms at 6 wk of disease were associated with worsening of decreased rCBF at the 1-yr follow-up.


CONCLUSIONS
With SPECT, rCBF changes, mostly slight and patchy or multifocal, were detected in patients with aseptic meningoencephalitis. Decreased rCBF was more frequent in patients with moderate-to-severe encephalitis, although the clinical use in predicting long-term outcomes in aseptic meningoencephalitis (e.g., TBE) seems limited.
Günther
G
G
Division of Infectious Diseases, Danderyd Hospital, Sweden.
Haglund
M
M
Mesko
L
L
Bremmer
S
S
Lindquist
L
L
Forsgren
M
M
Sköldenberg
B
B
Rudberg
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D018450:Disease Progression; D004675:Encephalitis, Tick-Borne / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018792:Encephalitis, Viral / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012016:Reference Values; D012039:Regional Blood Flow; D012727:Sex Characteristics; D019690:Technetium Tc 99m Exametazime; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime