Regional cerebral blood flow after human cardiac arrest. A hexamethylpropyleneamine oxime single photon emission computed tomographic study
R. O. Roine, J. Launes, P. Nikkinen, L. Lindroth and M. Kaste
Department of Neurology, University of Helsinki, Finland.
We studied 30 patients 24 hours after out-of-hospital cardiac arrest and 13
age-matched normal controls with the use of technetium Tc
99m-hexamethylpropyleneamine oxime single photon emission computed
tomography. All patients were followed up for 12 months or until death.
Frontal hypoperfusion (anteroposterior perfusion ratio, less than 0.90) was
observed in 23 patients (77%). In eight patients who remained comatose and
died, the total size of perfusion defects was larger (38% +/- 20%) than in
the 21 patients who recovered consciousness (24% +/- 14%), but the
anteroposterior ratio was similar in both of these patient groups (0.83 +/-
0.09) and significantly lower than in the controls (0.96 +/- 0.03). During
follow-up, both the anteroposterior perfusion ratio and the relative defect
size improved, but frontal hypoperfusion was still observed in seven of 13
patients. After cardiac arrest, regional cerebral blood flow is
characterized by frontal hypoperfusion that tends to improve over time but
that persists in most patients.
