Hemodynamic and metabolic changes in a patient with cerebral venous sinus thrombosis: evaluation using O-15 positron emission tomography.
The cerebral hemodynamics and oxygen metabolism before and after the recanalization of the occluded sinus were evaluated using O-15 positron emission tomography (PET) scanning in a 21-year-old woman with superior sagittal sinus thrombosis. During the initial presentation, there was increased regional cerebral blood volume (rCBV) in the left frontal and parietal lobes with moderately increased rCBV in the right parietal lobe. Recanalization of the occluded sinus resulted in a normalization of elevated rCBV in the frontal and parietal lobes and improvements of rCBF and regional cerebral metabolic rate for oxygen in the occipital lobe. Clinical improvement after recombinant tissue plasminogen activator therapy was accompanied by restoration of cerebral hemodynamics and oxygen metabolism, although magnetic resonance venography showed only partial recanalization of the occluded sinus. PET evaluation of the cerebral hemodynamics and oxygen metabolism may be of value in gaining further insight into pathophysiological characteristics of human cerebral venous sinus thrombosis.
Kawai
Nobuyuki
N
Department of Neurological Surgery, Kagawa University School of Medicine, 1750-1 Miki-cho, Kita-gun, Kagawa 761-0793, Japan. nobu@kms.ac.jp
Shindou
Atsushi
A
Masada
Tetsuya
T
Tamiya
Takashi
T
Nagao
Seigo
S
D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005260:Female; D006801:Humans; D010100:Oxygen / Q000378:metabolism*; D010104:Oxygen Radioisotopes / Q000493:pharmacokinetics*; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
D010104:Oxygen Radioisotopes; D010959:Tissue Plasminogen Activator; D010100:Oxygen