Cerebral blood flow imaging in arteriovenous malformation complicated by normal perfusion pressure breakthrough.
BACKGROUND
A patient with normal perfusion pressure breakthrough (NPPB) after surgical removal of an arteriovenous malformation (AVM) was evaluated using single photon emission computed tomography cerebral blood flow (CBF) imaging.


METHODS
A 48-year-old man suffered consciousness disturbance because of an intraventricular hemorrhage and underwent ventricular drainage. Cerebral angiography showed a medium-sized AVM in the left parietal lobe. Three months after the ictus, a left parietal craniotomy was performed and total removal of the AVM was achieved. A brain region adjacent to the AVM with preoperative decreased vasoreactivity to acetazolamide showed marked hyperperfusion after AVM excision. Hemorrhage subsequently occurred in this area.


CONCLUSIONS
CBF mapping seems to offer a noninvasive method for the preoperative identification of AVM patients at risk for NPPB, and to allow for early postoperative diagnosis of NPPB.
Ogasawara
K
K
Department of Neurosurgery and Cyclotron Research Center, Iwate Medical University, Morioka, Japan.
Yoshida
K
K
Otawara
Y
Y
Kobayashi
M
M
Yasuda
S
S
Doi
M
M
Ogawa
A
A
D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D001921:Brain / Q000098:blood supply*; D001929:Brain Edema / Q000175:diagnosis*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis*; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000098:blood supply; D011183:Postoperative Complications / Q000175:diagnosis*; D012039:Regional Blood Flow / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed