Volume and surface three-dimensional displays of Tc-99m HMPAO brain SPECT imaging in a chronic hypnosedative abuser

An alcohol- and diazepam-abusing patient underwent brain CT and SPECT imaging studies. The CT scan showed mild brain atrophy, whereas SPECT imaging using Tc-99m HMPAO showed a large lesion in the left cerebral hemisphere. The extent of lesion involvement was appreciated by three-dimensional displays. This finding was associated with a clinical presentation of hypnosedative withdrawal delirium (disorientation, impaired memory, rambling speech with loose associations, paranoia, ideation, restlessness, poor judgment). Tc-99m HMPAO SPECT may provide objective documentation of regional cerebral neurochemical alteration associated with hypnosedative abuse or hypnosedative withdrawal states, whereas surface and volume three-dimensional displays simplify and enhance brain SPECT image interpretation.