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Regional cerebral blood flow scintigraphy in tick-borne encephalitis and other aseptic meningoencephalitis
Unlabelled:
In a prospective study, regional cerebral blood flow (rCBF) was studied in patients with aseptic meningoencephalitis at 6 wk and 1 yr after onset of disease.
Methods:
Patients with tick-borne encephalitis ([TBE] n = 73) and meningoencephalitis of other etiology ([non-TBE] n = 56) were investigated with rCBF-scintigraphy (SPECT). SPECT images in the acute phase of disease and at long-term follow-up were analyzed for blood-flow disturbances and their localization in the central nervous system and were correlated to clinical course and outcome.
Results:
Decreased rCBF was seen in 50% of patients after 6 wk (TBE 49%, non-TBE 50%) and in 46% (TBE 47%, non-TBE 46%) after 1 yr. The decrease in rCBF was moderate in 18% and 11% at 6 wk and in 8% and 9% at the 1-yr follow-up of TBE and non-TBE patients, respectively. Reduced rCBF was significantly more common among patients with encephalitis than among those with meningitis, and more common in males. The distribution of cerebral flow changes was predominantly patchy or multifocal. At long-term follow-up, improvement in rCBF was seen in 28 of 109 patients (26%), but worsening of decreased rCBF was demonstrated in 19 of 109 (17%). In TBE patients, remaining neurological symptoms at 6 wk of disease were associated with worsening of decreased rCBF at the 1-yr follow-up.
Conclusion:
With SPECT, rCBF changes, mostly slight and patchy or multifocal, were detected in patients with aseptic meningoencephalitis. Decreased rCBF was more frequent in patients with moderate-to-severe encephalitis, although the clinical use in predicting long-term outcomes in aseptic meningoencephalitis (e.g., TBE) seems limited.
Insights
Regional cerebral blood flow (rCBF) was reduced in many patients with aseptic meningoencephalitis, particularly those with encephalitis. While some rCBF improvements occurred, predicting long-term outcomes using SPECT scans remains limited.
Area of Science:
- Neurology
- Neuroimaging
- Infectious Diseases
Background:
- Aseptic meningoencephalitis, including tick-borne encephalitis (TBE), can cause significant neurological impairment.
- Understanding the long-term effects on cerebral blood flow is crucial for patient management.
Purpose of the Study:
- To investigate regional cerebral blood flow (rCBF) changes in patients with aseptic meningoencephalitis.
- To correlate rCBF findings with clinical presentation and long-term outcomes using SPECT imaging.
Main Methods:
- Prospective study involving 73 TBE and 56 non-TBE patients.
- rCBF assessed using SPECT scintigraphy at 6 weeks and 1 year post-onset.
- Analysis of blood-flow disturbances, localization, and correlation with clinical course.
Main Results:
- Decreased rCBF observed in 50% at 6 weeks and 46% at 1 year.
- Reduced rCBF was more common in encephalitis patients and males, with patchy/multifocal distribution.
- 26% showed rCBF improvement, while 17% worsened; TBE patients with early symptoms had worse rCBF at 1 year.
Conclusions:
- SPECT detected mostly slight, patchy/multifocal rCBF changes in aseptic meningoencephalitis.
- Decreased rCBF was more frequent in moderate-to-severe encephalitis.
- Clinical utility of SPECT for predicting long-term outcomes in aseptic meningoencephalitis appears limited.
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