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  • 1
    ISSN: 1432-1920
    Keywords: I-123 IMP ; Brain SPECT ; Cerebral infarction ; Pathophysiological
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-eight patients with cerebral infarction were examined by brain SPECT with I-123 IMP a total of 46 times from Day 2 to Day 84 after the onset of stroke. Depending on the pattern of change in the abnormal accumulation of I-123 IMP between the early and delayed images, the patients were classified into one of five types. The number of patients in each type and the number of days after infarction at which each type occurred were as follows: Type (I),n=5 and 4±2 days; Type (II),n=8 and 12±4 days; Type (III),n=17 and 21±11 days; Type (IV),n=13 and 38±18 days; and Type (V),n=3 and 60±16 days. In 12 patients, 30 brain SPECT were performed that showed the chronological evolution of infarction in sequence from Types (I) to (IV). Hyperactivity in the early image was seen in Type (I) with a subsequent image defect, while in Type (II) there was persistent hyperactivity. Hypoactivity in the early image was seen in Types (III), (IV), and (V), and the activity in the delayed image gradually decreased as the process of infarction terminated. The early image reflected the distribution of lipophilic I-123 IMP, indicating regional cerebral blood flow, while the delayed image showed the distribution of hydrophilic I-123 IMP metabolites superimposed on that of lipophilic I-123 IMP which had accumulated in the brain at the first extraction. Combining the early and delayed images of I-123 IMP brain SPECT may help to understand the evolution of cerebral infarction.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1920
    Keywords: Single photon emission computed tomography ; 123I-IMP ; Cerebral infarction ; Cerebral thrombosis ; Acetazolamide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To identify regional vasodilatory capacity and its sequential change, we evaluated prospectively a total of 78 acetazolamide tests in 51 patients with occlusion or greater than 75% stenosis of the carotid or middle cerebral arteries. The relative distribution of cerebral blood flow was determined by single photon emission computed tomography usingN-isopropyl-p-[123I]-iodoamphetamine before and after intravenous injection of acetazolamide. Reduced vasodilatory capacity was demonstrated in 20 patients (38%), including 5 patients with hemodynamic transient ischemic attacks or infarction. Follow-up acetazolamide tests revealed asymptomatic progression of the arterial lesion (from stenosis to occlusion) in 1 patient and almost complete improvement of vasodilatory capacity in 5 patients, including 3 without surgical intervention. During an average follow-up period of 18.5 months, 4 patients died from cardiac causes or neoplasm; no neurovascular events occurred. Much larger numbers of patients with longer observation periods will be necessary to clarify the contribution of chronic hemodynamic failure to subsequent stroke. However, the present data indicate that the acetazolamide test is useful for assesssing the course of high grade stenosis or occlusion of major cerebral arteries.
    Type of Medium: Electronic Resource
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