Evaluation of the regional blood circulation of the hindbrain by dynamic computed tomography

Permanent or transient reduction of blood flow to the hindbrain is often responsible for symptoms of disequilibrium, dizziness and occasionally sensorineural hearing loss. Recent advances in CT technology and the development of continuous rapid rotational CT brain scanning now permit a practical and relatively non-invasive method for evaluation of regional brain circulation. It is the purpose of this presentation to review displays of normal CT hindbrain circulation and compare them with displays from patients with hindbrain ischemia. Dynamic CT provides a useful clinical index of brain blood circulation and can be used to detect and differentiate insufficiency due to pathology of the brain, of the artery supplying it, or of the cardiovascular system. Finally, the quantitative hemodynamic benefit from surgery of the carotid or vertebral arteries can be properly evaluated by this technique.