Diffusion-perfusion mismatch in symptomatic vasospasm after subarachnoid hemorrhage.
Diffusion-weighted and perfusion-weighted magnetic resonance (MR) imaging were investigated as a method to detect diffusion-perfusion mismatch in the early stages of vasospasm in 17 patients with acute subarachnoid hemorrhage after aneurysm clipping. Single photon emission computed tomography (SPECT) with N-isopropyl-p-[(123)I]iodoamphetamine was also performed. Diffusion-perfusion mismatch was clearly identified in the 3 patients who manifested clinical deterioration. Perfusion-weighted imaging showed increased mean transit time, normal cerebral blood flow, and increased or normal cerebral blood volume. SPECT revealed no earlier signs of vasospasm. Diffusion-perfusion mismatch was clearly demonstrated in the early stages of vasospasm, so may be useful for early identification of ischemia in vasospasm and initiating appropriate treatment.
Ohtonari
Tatsuya
T
Department of Neurosurgery, Cerebrovascular Center, Niigata Rosai Hospital, Joetsu, Japan. otonari1@alpha.ocn.ne.jp
Kakinuma
Kenichi
K
Kito
Tomohiro
T
Ezuka
Isamu
I
Kanazawa
Tsutomu
T
D000368:Aged; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D020367:Iofetamine; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011859:Radiography; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D020301:Vasospasm, Intracranial / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*
D020367:Iofetamine