Cerebral hemodynamic disturbance in dural arteriovenous fistula with retrograde leptomeningeal venous drainage: a prospective study using 123I-iodoamphetamine single photon emission computed tomography
| Autor: | Yuichiro Fukumoto, Toru Horikoshi, Takashi Yagi, Hiroshi Onishi, Hiroyuki Kinouchi, Koji Hashimoto, Kazuya Kanemaru, Takuma Wakai, Hideyuki Yoshioka, Yoshihisa Nishiyama, Takako Umeda |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Encephalopathy Arteriovenous fistula Infarction Hyperemia Single-photon emission computed tomography Severity of Illness Index Neurosurgical Procedures Iodine Radioisotopes Edema medicine Humans Prospective Studies Prospective cohort study Aged Retrospective Studies Aged 80 and over Central Nervous System Vascular Malformations Tomography Emission-Computed Single-Photon Brain Diseases medicine.diagnostic_test business.industry Endovascular Procedures Hemodynamics Reproducibility of Results Middle Aged medicine.disease Magnetic Resonance Imaging Amphetamine Cerebral blood flow Regional Blood Flow Cerebral hemodynamics Cerebrovascular Circulation Drainage Female Radiology medicine.symptom business |
| Zdroj: | Journal of Neurosurgery. 123:110-117 |
| ISSN: | 1933-0693 0022-3085 |
| Popis: | OBJECT The severity of cerebral hemodynamic disturbance caused by retrograde leptomeningeal venous drainage (RLVD) of a dural arteriovenous fistula (dAVF) is related to neurological morbidity and unfavorable outcome. However, the cerebral hemodynamics of this disorder have not been elucidated well. The aim of this study was to assess the relationship between the cerebral venous congestive encephalopathy represented as a high-intensity area (HIA) on T2-weighted MR images and the cerebral hemodynamics examined by 123I-iodoamphetamine (IMP) single photon emission computed tomography (SPECT), as well as the predictive value of 123I-IMP SPECT for the development and reversibility of venous congestion encephalopathy. METHODS Based on the pre- and posttreatment T2 HIAs associated with venous congestion encephalopathy, patients were divided into 3 groups: a normal group, an edema group, and an infarction group. The regional cerebral blood flow (rCBF) at the region with RLVD was analyzed by 123I-IMP SPECT, and the results were compared among the groups. RESULTS There were 11, 6, and 3 patients in the normal, edema, and infarction groups, respectively. No patients in the normal group showed any symptoms related to venous congestion. In contrast, all patients in the edema and infarction groups developed neurological symptoms. The rCBF in the edema group was significantly lower than that in the normal group, and significantly higher than that in the infarction group. The cerebral vascular reactivity (CVR) of the infarction group was significantly lower than that of the normal and edema groups. After treatment, the neurological signs disappeared in the edema group, but only partial improvement was seen in the infarction group. The rCBF also significantly increased in the normal and edema groups, but not in the infarction group. CONCLUSIONS Quantitative rCBF measurement is useful for evaluating hemodynamic disturbance in dAVF with RLVD. The reduction of rCBF was strongly correlated with the severity of venous congestive encephalopathy, and loss of CVR is a reliable indicator of irreversible venous infarction caused by RLVD. |
| Databáze: | OpenAIRE |
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