Metabolic changes after revascularization in a patient with innominate artery occlusion by localized in vivo proton magnetic resonance spectroscopy.
Localized in vivo proton magnetic resonance spectroscopy ((1)H-MRS) has been used to measure the metabolic status of the human brain in a non-invasive manner; thus, it is often called "a non-invasive biochemical assay". MRS is more sensitive than magnetic resonance imaging (MRI) in detecting ischemic damage by measuring the metabolic changes that occur prior to the anatomic changes. We report a patient who presented with innominate artery occlusion and symptoms of posterior circulation insufficiency and showed favorable metabolic changes by (1)H-MRS after revascularization. He showed no visible lesion in brain MRI, but in (1)H-MRS, decreased N-acetylaspartate (NAA) signal was noted in a resting state. After revascularization, both symptomatic improvement and recovery of NAA signal were observed. (1)H-MRS may provide valuable clinical information in diagnosis and management of cerebral hypoperfusion at a much earlier stage prior to the anatomic changes.
Cho
Yong Pil
YP
Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea. ypcho@knh.co.kr
Lee
Jung Hee
JH
Kim
Geun Eun
GE
D001157:Arterial Occlusive Diseases / Q000473:pathology; D016122:Brachiocephalic Trunk / Q000473:pathology* / Q000601:surgery; D001921:Brain / Q000378:metabolism*; D002548:Cerebral Revascularization; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011522:Protons
D011522:Protons