Journal article
Crossed cerebellar diaschisis associated with balloon test occlusion of the carotid artery
Nuclear medicine communications, Vol.15(6), pp.448-454
06/1994
DOI: 10.1097/00006231-199406000-00009
PMID: 8078641
Abstract
Tc-hexamethylpropyleneamine oxime (Tc-HMPAO) single photon emission computed tomographic (SPECT) brain imaging performed in conjunction with balloon test occlusion of the carotid artery has been used to assess risk of neurologic sequelae that might follow permanent surgical ligation of the artery. The predictive value of cortical hypoperfusion during temporary carotid occlusion for adverse neurologic events has been debated in previous publications. We believe that the risk of an adverse event is greater when a reduction in cortical perfusion during balloon test occlusion is associated with crossed cerebellar diaschisis (CCD). To test our hypothesis we evaluated the results of 27 Tc-HMPAO SPECT brain studies obtained in association with balloon test occlusions of the carotid artery. In each case we correlated clinical outcome with the presence or absence of regional decreases in cerebral perfusion and CCD. All of the 27 patients were free of neurologic symptoms during the balloon test occlusion. Seventeen of the 27 scintigraphic studies were felt to be abnormal, showing cortical perfusion defects all on the side of the occlusion. Among these 17 patients, five demonstrated CCD. Four of these five CCD patients showed evidence for cerebral cortical ischaemia on the side of the temporary carotid occlusion either shortly after the procedure or following carotid artery sacrifice. Of the remaining 12 patients with regionally reduced cerebral perfusion and no CCD, none showed evidence for cortical ischaemia in association with balloon test occlusion, and five of these 12 patients had carotid ligation without subsequent neurologic sequelae. Our results provide evidence to support our hypothesis that when CCD accompanies regional hypoperfusion on a brain SPECT study obtained after injection of Tc-HMPAO during balloon test occlusion of the carotid artery, the patient is likely to be at increased risk of adverse neurologic sequelae following carotid sacrifice.
Details
- Title: Subtitle
- Crossed cerebellar diaschisis associated with balloon test occlusion of the carotid artery
- Creators
- M NATHAN - University of IowaD BUSHNELLD KAHNT SIMONSONP KIRCHNER
- Resource Type
- Journal article
- Publication Details
- Nuclear medicine communications, Vol.15(6), pp.448-454
- Publisher
- Lippincott-Raven Publishers
- DOI
- 10.1097/00006231-199406000-00009
- PMID
- 8078641
- ISSN
- 0143-3636
- eISSN
- 1473-5628
- Language
- English
- Date published
- 06/1994
- Academic Unit
- Radiology
- Record Identifier
- 9984051552502771
Metrics
12 Record Views