Document Detail


Crossed cerebellar diaschisis associated with balloon test occlusion of the carotid artery.
MedLine Citation:
PMID:  8078641     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
99Tcm-hexamethylpropyleneamine oxime (99Tcm-HMPAO) single photon emission computed tomographic (SPECT) brain imaging performed in conjunction with balloon test occlusion of the carotid artery has been used to assess risk of neurologic sequelae that might follow permanent surgical ligation of the artery. The predictive value of cortical hypoperfusion during temporary carotid occlusion for adverse neurologic events has been debated in previous publications. We believe that the risk of an adverse event is greater when a reduction in cortical perfusion during balloon test occlusion is associated with crossed cerebellar diaschisis (CCD). To test our hypothesis we evaluated the results of 27 99Tcm-HMPAO SPECT brain studies obtained in association with balloon test occlusions of the carotid artery. In each case we correlated clinical outcome with the presence or absence of regional decreases in cerebral perfusion and CCD. All of the 27 patients were free of neurologic symptoms during the balloon test occlusion. Seventeen of the 27 scintigraphic studies were felt to be abnormal, showing cortical perfusion defects all on the side of the occlusion. Among these 17 patients, five demonstrated CCD. Four of these five CCD patients showed evidence for cerebral cortical ischaemia on the side of the temporary carotid occlusion either shortly after the procedure or following carotid artery sacrifice. Of the remaining 12 patients with regionally reduced cerebral perfusion and no CCD, none showed evidence for cortical ischaemia in association with balloon test occlusion, and five of these 12 patients had carotid ligation without subsequent neurologic sequelae.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M A Nathan; D L Bushnell; D Kahn; T M Simonson; P T Kirchner
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nuclear medicine communications     Volume:  15     ISSN:  0143-3636     ISO Abbreviation:  Nucl Med Commun     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-09-30     Completed Date:  1994-09-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  448-54     Citation Subset:  IM    
Affiliation:
University of Iowa Hospital and Clinics, Department of Radiology, Iowa City.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Balloon Dilatation
Brain / radionuclide imaging*
Carotid Artery, Common / physiology*
Carotid Artery, Internal / physiology*
Cerebellar Diseases / etiology*,  radionuclide imaging*
Cerebral Infarction / epidemiology*
Cerebrovascular Circulation / physiology*
Female
Humans
Male
Middle Aged
Organotechnetium Compounds / diagnostic use*
Oximes / diagnostic use*
Postoperative Complications / epidemiology
Predictive Value of Tests
Risk Factors
Technetium Tc 99m Exametazime
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Organotechnetium Compounds; 0/Oximes; 100504-35-6/Technetium Tc 99m Exametazime

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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