sodium-pertechnetate-tc-99m and Hematoma--Subdural

Brain scintigraphy was performed for differential diagnosis of suspected subdural hemorrhage in a 79-year-old woman. Planar pertechnetate (99mTcO4-) brain scan with AP, PA, lateral and vertex projections was planned. The procedure was started with AP-projection, continuing with lateral projections. After these images the patient was determined dead and the planned scannings were aborted. There was a clear difference in the intracranial uptake (choroid plexuses) in the lateral views as well as in the uptake in the venous sinuses. The findings in the AP view were normal and no signs of subdural hemorrhage were observed. The patient died during a routine nuclear medicine procedure, and cessation of intracranial circulation was observable on 99mTcO4- scans; the lack of uptake in cerebral sinuses confirmed the lack of intracerebral flow. In this rare case, brain death could be timed accurately using a static nuclear medicine procedure. Autopsy confirmed sudden brain circulatory disorders and general arteriosclerosis.

Topics: Aged; Brain; Brain Death; Cerebrovascular Circulation; Death, Sudden; Fatal Outcome; Female; Forensic Medicine; Hematoma, Subdural; Humans; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

The cause of hemispheric swelling and high intracranial pressure after acute subdural hematoma is unknown, yet this is a major cause of death related to this condition. To investigate whether vascular engorgement is the cause of this form of hemisphere swelling, we have autoradiographically mapped regional cerebral blood flow before and after removal of acute subdural hematoma in a rat model. Hyperemia was patchy and infrequent. The major cause of the significant hemisphere swelling seen after hematoma removal was enlargement of the zone of focal tissue ischemia and edema under the hematoma.

Topics: Acute Disease; Animals; Autoradiography; Brain Edema; Brain Ischemia; Brain Mapping; Cerebrovascular Circulation; Hematoma, Subdural; Male; Postoperative Complications; Radionuclide Imaging; Rats; Rats, Inbred Strains; Sodium Pertechnetate Tc 99m

The radionuclide brain scans performed on a gamma camera (GC scans) in 146 patients over 65 years of age during a 6-month period are reviewed. Forty-four scans (30.1%) were reported as showing an abnormality. Three patients subsequently underwent surgery and drug therapy was commenced in 11 cases. However, in most cases the GC scan proved unhelpful in the patients' management. The usage and role of GC scanning in elderly patients admitted with a neurological disorder is examined.

Topics: Aged; Brain; Brain Diseases; Brain Neoplasms; Dementia; Diagnostic Tests, Routine; False Negative Reactions; Female; Hematoma, Subdural; Humans; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Bilateral subdural haematoma is not a rare disorder, but only a few cases diagnosed at brain scintigraphy have been reported. Bilateral subdural haematoma was demonstrated at scintigraphy in a 66-year-old man. Subsequent computerized-tomography scanning of the brain also demonstrated the lesion. After bilateral burr-hole aspiration, the patient made a good recovery.

Topics: Aged; Brain; Hematoma, Subdural; Humans; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m