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A Serial Study With Single Photon Emission Computed Tomography

Mario Rango, MD; Livia Candelise, MD; Daniela Perani, MD; Cristina Messa, MD; Guglielmo Scarlato, MD; Nicola Canal, MD; Massimo Franceschi, MD; Ferrucio Fazio, MD

Arch Neurol. 1989;46(12):1318-1322.

Abstract
• We studied brain cortical radioactive tracer activity in a consecutive series of nine patients with acute hemispheric ischemic stroke at their first cerebral ischemic episode. Results from N,N,N-trimethyl-N- (2-hydroxy-3-methyl-5-[123-l]iodobenzyl)-1,3 propanediamine-2HCI (four patients) and technetium Tc 99m hexamethylpropyleneamine oxime (five patients) single photon emission computed tomographic studies were compared with x-raycomputed tomography (CT) and clinical findings within the first 48 hours, on day 10, and on day 30 after the clinical ictus. Cortical hypoactivity agreeing with the clinical findings was found on all initial scans but not in the follow-up studies. Cortical activity on the affected side in patients with stroke was significantly lower when compared with cortical activity in sex- and age-matched controls (n = 21). Computed tomography (with contrast) was less sensitive in detecting the ischemic lesions. These studies demonstrate that in the acute phase of stroke there is a single photon emission computed tomographic cortical disturbance that agrees with clinical findings, even when computed tomography scan infarction is limited to subcortical structures.

Author Affiliations
From the Istituto di Clinica Neurologica (Drs Rango, Candelise, and Scarlato), Dipartimento di Tecnologie Biomediche (Drs Perani, Messa, and Fazio), and Clinica Neurologica IV (Drs Canal and Franceschi), Istituto San Raffaele, Università degli Studi di Milano, Italy.

Footnotes
Accepted for publication December 30, 1988.

Read in part before the 40th annual meeting of the American Academy of Neurology, Cincinnati, Ohio, April 20, 1988.

Reprint requests to Istituto di Clinica Neurologica, Università degli Studi, Via F Sforza 35, 20122 Milano, Italy (Dr Rango).

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