title: [Value of brain perfusion SPECT in the follow-up of patients surgically treated for chronic adult hydrocephalus syndrome].
abstract: OBJECTIVE
  The aim of this study was to characterize regional cerebral blood flow in patients with Adult Hydrocephalus Syndrome (AHS) and to evaluate the changes in brain perfusion after surgical derivation treatment.
  
  
  METHODS
  20 patients with AHS (age: 72 +/- 14, 12 men) were studied before and six months after surgery. All patients underwent a brain perfusion SPECT (99mTc-HMPAO) prior to surgery and at 6 months post-surgery. Semi-quantitative analysis was done for brain uptake: 0=Normal, 1=Mild, 2=Moderate, 3= Severe, 4=No uptake. The severity of ventricular dilatation was assessed by classifying the intensity and extension of subcortical defects: 0=Normal, 1=Mild, 2=Moderate, 3=Severe. The scores of the pre- and post-surgical studies were compared using the Student-t test.
  
  
  RESULTS
  A global reduction of brain uptake was observed (mean score 12.85), mainly in frontal, parietal and temporal lobes, with a significant improvement in post surgical studies (mean score 6, p<0,001). After surgery, 16 (80%) of the 20 patients improved brain uptake. In relationship to subcortical uptake, 5 patients showed mild defects, 9 moderate defects and 6 patients presented severe uptake reduction. In post-surgical studies 15 (75%) patients improved almost one degree in the subcortical score and 65% of the patients showed a normal or mild subcortical uptake reduction.
  
  
  CONCLUSIONS
  Brain perfusion SPECT is useful in patients with AHS, detecting brain perfusion defects and evaluating cerebral blood flow improvement after shunt operation.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Díez Castro
authors.forename: J
authors.initials: J
authors.lastname: Castell Conesa
authors.forename: M A
authors.initials: MA
authors.lastname: Poca
authors.forename: A
authors.initials: A
authors.lastname: Rubió Rodríguez
authors.forename: C
authors.initials: C
authors.lastname: Lorenzo Busquets
authors.forename: T
authors.initials: T
authors.lastname: Canela Coll
authors.forename: M
authors.initials: M
authors.lastname: Simó Perdigó
authors.forename: S
authors.initials: S
authors.lastname: Aguadé Bruix
authors.forename: M
authors.initials: M
authors.lastname: Mataró Serrat
authors.forename: J
authors.initials: J
authors.lastname: Sahuquillo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D002557:Cerebrospinal Fluid Shunts; D002560:Cerebrovascular Circulation; D003704:Dementia / Q000209:etiology; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000000981:diagnostic imaging* / Q000523:psychology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012720:Severity of Illness Index; D019690:Technetium Tc 99m Exametazime / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime