technetium-tc-99m-exametazime and Virus-Diseases

Our purpose was to investigate cerebral blood flow disturbances in patients with bacterial and viral meningoencephalitis.. Forty-two patients with acute bacterial and viral meningoencephalitis and 14 control subjects were studied using 99mTc-hexamethylpropyleneamine oxime (HMPAO) single-photon emission computed tomography (SPECT). SPECT images were evaluated semiquantitatively. The results were compared with clinical severity of the meningoencephalitis assessed at the time of the SPECT study with the Hunt and Hess scale, with separately recorded focal clinical signs, and with the Glasgow outcome scale (GOS) after 3 weeks.. Count density values were significantly reduced in patients with bacterial meningoencephalitis as compared with the control subjects. Inhomogeneous tracer accumulation assessed by asymmetry indexes was significantly greater in patients than in the control group. With increasing Hunt and Hess scores, the count density values decreased and the asymmetry indexes increased. Patients with a poor outcome (GOS 1 to 3) had significantly higher asymmetry indexes and lower CDV values than did patients with a good outcome.. Global and focal alterations of cerebral perfusion are frequent in bacterial and viral meningoencephalitis and correlate with acute clinical state.

Topics: Adult; Bacterial Infections; Cerebrovascular Circulation; Female; Humans; Male; Meningoencephalitis; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Virus Diseases

We compared Tc-99m HMPAO brain SPECT and MRI with the clinical findings in a case of a 14-year-old boy with post-infectious cerebellitis.. Tc-99m HMPAO brain SPECT scan showed marked reduction in perfusion to the left anterior lobe, left lateral hemisphere, and left posterior lobe of the cerebellum. The MRI showed a limited region of abnormal signal in the mid posterior left cerebellar hemisphere. Since the patient's overall neurological deficit was characterized by ataxia, nystagmus, head and body titubation, dysmetria, dysdiadochokinesia, loss of normal check, and rebound testing attributed to the involvement of the anterior, lateral, and posterior lobes of the left cerebellar hemisphere, the Tc-99m HMPAO brain SPECT finding correlated better with the extent of functional neurological deficits.. Tc-99m HMPAO brain SPECT may better assess cerebellar signs and symptoms in cerebellitis since the blood flow abnormalities correlated with dysfunction of the cerebellum, whereas the MRI abnormalities did not encompass the scope of the neurological deficits.

Topics: Adolescent; Cerebellar Diseases; Cerebellum; Encephalitis; Humans; Magnetic Resonance Imaging; Male; Radiopharmaceuticals; Respiratory Tract Infections; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Virus Diseases

Pseudomigraine with pleocytosis is a benign and autolimited syndrome. The etiology has been related to viral infection, but its pathophysiology is not yet well identified. To investigate this point, and to see if there were changes in cerebral blood flow (as in migraine), we performed single photon emission computed tomography (SPECT) studies in four patients who fulfilled the diagnostic criteria for this syndrome. This was done during the acute phase and we repeated SPECT after resolution of the syndrome in two of them. We found a reduction in brain blood flow on the side of origin of the neurological deficits during the acute phase. This normalized after recovery of the syndrome. The finding suggests that the neurological deficits in this syndrome could be produced by a spreading depression-like mechanism similar to that proposed for migraine with aura.

Topics: Adult; Aphasia; Cerebrovascular Circulation; Cortical Spreading Depression; Female; Headache; Hemiplegia; Humans; Leukocytosis; Male; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Virus Diseases