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Cortical hypoperfusion in symptomatic West syndrome. A SPECT study
L Sztriha1, A R al Suhaili, V Prais
1Department of Paediatrics, FMHS, UAE University, Al Ain, United Arab Emirates.
European Journal of Radiology
|July 1, 1997
Summary
West syndrome is linked to reduced brain perfusion in specific cortical areas. These perfusion abnormalities may indicate underlying brain issues and encephalopathy from infantile spasms.
Area of Science:
- Neuroscience
- Medical Imaging
- Pediatric Neurology
Background:
- West syndrome, characterized by infantile spasms and hypsarrhythmia, is associated with altered brain metabolism and perfusion.
- Previous studies using PET and SPECT have indicated changes in glucose utilization and cerebral perfusion in West syndrome.
Purpose of the Study:
- To investigate cerebral perfusion patterns in patients with symptomatic West syndrome using technetium-99m-labeled hexamethylpropyleneamine oxime (99mTc-HMPAO) SPECT.
- To compare cortical and basal ganglia perfusion in West syndrome patients with healthy controls.
Main Methods:
- SPECT imaging with 99mTc-HMPAO was performed on seven patients with West syndrome.
- Automated and manual delineation of regions of interest in the cerebral cortex, basal ganglia, and cerebellum.
- Comparison of cortical/cerebellar and basal ganglia/cerebellar HMPAO uptake ratios between patients and controls.
Main Results:
- Significantly reduced cerebral perfusion was observed in the bilateral anterior, mid frontal, and perisylvian cortex.
- Reduced perfusion was also noted in the left posterior frontal and temporal areas.
- No well-localized focal cortical perfusion changes were found, and basal ganglia perfusion was normal.
Conclusions:
- Diffuse abnormalities in cortical perfusion are present in West syndrome patients.
- These perfusion deficits may suggest a combination of pre-existing brain pathology and encephalopathy secondary to hypsarrhythmia and infantile spasms.