technetium-tc-99m-exametazime and Poisoning

Abnormal regional cerebral blood flow in patients with acute carbon monoxide (CO) and organophosphate (OP) poisoning was examined using (99m)Tc-hexamethylpropylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) in fourteen patients. We evaluated the predictive significance of acute phase brain SPECT findings for long-term neuropsychological sequelae. Changes were found in the frontal, temporal, parietal lobes within the first week after both types of poisoning. The distribution of the hypoperfused cerebral areas as demonstrated by (99m)Tc-HMPAO imaging was similar in the two groups during the acute phase. Neuropsychological sequelae developed in five patients poisoned with OP and six with CO. Patients who had SPECT findings heterogeneously or in the temporal or frontal lobes displayed disorientation. Those with fronto-parietal and frontal lobe changes displayed mental confusion. Parkinsonism also was observed in patients with parieto-occipital, parietal and frontal lobe lesions. The distribution of these lesions appears to predict the long term sequelae of these poisonings, though additional studies with larger numbers of patients are needed to confirm the role of SPECT imaging in both OP and CO poisonings.

Topics: Adult; Brain; Carbon Monoxide Poisoning; Carboxyhemoglobin; Female; Humans; Male; Neuropsychological Tests; Organophosphate Poisoning; Poisoning; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

A case of 49 years old woman with acute, severe suicidal carbofuran poisoning is described. The lowest activity of AChE was 0 IU/L. Because carbamates lead to multiorgan damages, especially affect central nervous system, computer tomography of the brain (CT) and examination of regional cerebral blood flow (99mTc-ECD SPECT) were done. No pathological changes were found in CT. 99mTc-ECD SPECT performed on 14th day of hospitalization, revealed disturbed regional cer- ' ebral flow generally in frontal and occipital lobes. Results of neuropsychological examination were pathological too.

Topics: Carbofuran; Cerebrovascular Disorders; Depression; Female; Humans; Insecticides; Mental Disorders; Middle Aged; Poisoning; Radiopharmaceuticals; Regional Blood Flow; Suicide, Attempted; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Treatment Outcome