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[99mTc-HMPAO SPECT in the brain death--a case report]
T Tsuchida1, N Sadato, S Nishizawa
1Department of Radiology and Nuclear Medicine, Kyoto University Faculty of Medicine.
Kaku Igaku. the Japanese Journal of Nuclear Medicine
|June 1, 1993
Summary
Brain SPECT imaging using 99mTc-d,l-hexamethyl-propyleneamine oxime (HMPAO) confirmed preserved cerebral blood flow initially, then cessation, aiding brain death diagnosis. This technique is crucial for confirming brain death, especially when clinical criteria are met but blood flow is initially present.
Area of Science:
- Neurology
- Nuclear Medicine
- Radiology
Background:
- Clinical diagnosis of brain death relies on established neurological criteria.
- Cerebral blood flow assessment is critical for confirming brain death.
- 99mTc-d,l-hexamethyl-propyleneamine oxime (HMPAO) is a radiotracer used in brain SPECT imaging.
Observation:
- A 78-year-old male, clinically diagnosed with brain death, underwent two brain SPECT scans.
- The initial SPECT scan showed tracer accumulation, indicating preserved cerebral blood flow.
- A follow-up SPECT scan three days later revealed a complete cessation of cerebral blood flow.
Findings:
- The initial SPECT finding of preserved cerebral blood flow contradicted the clinical diagnosis of brain death.
- The subsequent SPECT scan demonstrating absent blood flow supported the diagnosis.
- This case highlights the importance of dynamic assessment of cerebral blood flow.
Implications:
- Brain perfusion SPECT serves as a vital confirmatory test for brain death diagnosis.
- In cases with initially preserved cerebral blood flow, brain death diagnosis requires caution and further investigation.
- SPECT imaging can differentiate between states of absent and preserved cerebral perfusion, impacting patient management and prognosis.