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Journal of Neurosurgical Sciences 2005 September;49(3):117-24


language: English

Serial changes in the regional cerebral blood flow of patients with hypertensive intracerebral hemorrhage - long-term follow-up SPECT study

Murakami M. 1, Fujioka S. 1, Oyama T. 1, Kuroda J. 1, Tajiri S. 1, Kuratsu J. 2

1 Department of Neurosurgery Saiseikai Kumamoto Hospital Chikami, Kumamoto, Japan 2 Department of Neurosurgery Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan


We analyzed serial changes in the regional cerebral blood flow (rCBF) of 13 patients with intracerebral hemorrhage by single photon emission computed tomography (SPECT) during the acute- to chronic stage (2 hr to 55 weeks). The 99mTc-ethyl cisteinate dimmer (99mTc-ECD) was used as the nuclear mediator. The SPECT timing within 48 hours after the onset was considered to be acute stage, from 48 hours to 4 weeks to be subacute stage, and after 4 weeks to be chronic stage. The region of interest was each hemisphere in the whole brain without ventricles at the thalamic level. For semi-quantitative analysis of rCBF, we used the Brain Uptake Ratio method. Of the 13 patients (mean age 65.5 years), 3 had thalamic-, 4 putaminal-, 5 subcortical-, and one a cerebellar hemorrhage; the hematoma volume varied from 4-50 ml (<20 ml, n=9; 20-30 ml, n=1; >30 ml, n=3; mean 17 ml). The rCBF changes during the long-term follow-up were classified as increase-, decrease-, and unchanged type. Of 5 patients with increased rCBF, 4 made a good recovery and one was severely disabled; of 5 patients with decreased rCBF, 1 made a good recovery, 3 were moderately-, and one was severely disabled. All 3 patients with unchanged rCBF were moderately disabled. Our findings suggest that among patients with hypertensive intracerebral hemorrhage, those with increased rCBF over time may have a favorable outcome. We further need more cases with intracerebral hemorrhage to clarify this trend.

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