Single-photon emission computed tomography and early death in acute ischemic stroke

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Acute supratentorial brain infarction requires accurate early assessment of cerebral blood flow.
• Predicting outcomes such as early mortality and functional recovery is crucial for patient management.

Purpose of the Study:

• To evaluate the utility of single-photon emission computed tomography (SPECT) in quantifying regional cerebral blood flow deficits post-stroke.
• To determine the correlation between the extent of initial blood flow deficit and patient outcomes, including mortality and functional status.

Main Methods:

• 26 patients with supratentorial brain infarction underwent SPECT using thallium-201-labeled diethyldithiocarbamate within 24 hours of stroke.
• Regional cerebral blood flow deficits were assessed semiquantitatively by two independent observers.
• Outcomes including the Barthel Index, motricity index, and early mortality were evaluated at 6 months post-stroke.

Main Results:

• The size of the initial regional cerebral blood flow deficit showed a negative correlation with the Barthel Index score at 6 months.
• No significant correlation was found between the initial flow deficit and the motricity index score at 6 months.
• A strong correlation was observed between larger initial flow deficits and early death from tentorial herniation (p = 0.00018).

Conclusions:

• SPECT provides a simple, semiquantitative method for assessing immediate blood flow disturbances after acute stroke.
• The magnitude of the initial cerebral blood flow deficit is a significant predictor of early mortality due to tentorial herniation.
• SPECT's ability to measure regional cerebral blood flow makes it valuable for acute stroke research and outcome prediction.