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SPECT measurement of cerebral hemodynamics in transient ischemic attack patients--evaluation of pathogenesis and detection of misery perfusion
Authors:H Toyama  G Takeshita  A Takeuchi  K Ejiri  H Maeda  K Katada  S Koga  N Ishiyama  T Kanno
Abstract:To evaluate the cerebral hemodynamics and the pathogenesis by regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV), 42 transient ischemic attack (TIA) patients and 9 normal volunteers were studied using SPECT. We classified these patients into Group A (n = 23: no occlusion or stenosis of the internal carotid or middle cerebral artery; non large vessel disease) and Group B (n = 19: chronic occlusion or severe stenosis of the internal carotid or middle cerebral artery; large vessel disease). We obtained rCBF with 133Xe inhalation and rCBV with 99mTc-red blood cells. Of 9 normal volunteers aged 43-70 yr (mean age 59.8 +/- 8.3 yr), the mean rCBF was 45.8 +/- 5.1 (ml/100 g brain/min), the mean rCBV was 4.0 +/- 0.4 (ml/100 g brain). The examination was done by comparing the values of the affected hemispheres of Group A and Group B patients with the mean rCBF and the mean rCBV of normal volunteers. Eleven out of Group A patients and 15 out of Group B patients showed decreased rCBF. But of those patients, no patients of Group A showed increased rCBV and 6 out of 19 Group B patients showed increased rCBV. Thromboembolic mechanism which is of Group A patients and Group B patients without increased rCBV, and hemodynamic mechanism which is of Group B patients with increased rCBV were considered as the main cause of TIA. Decreased rCBF and increased rCBV in Group B patients can be assumed as the misery perfusion as reported in PET studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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