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Technetium-99m-HMPAO SPECF Cerebral Blood Flow Study in Children with Craniosynostosis

Departments of Nuclear Medicine, Pediatric Surgery and Neurology, AIIMS and SBISR, New Delhi, India

Correspondence: For correspondence or reprints contact: Dr. A.K. Padhy, Additional Professor, Dept. of Nuclear Medicine, AIIMS, New Delhi, 110029, India.

ABSTRACT

Premature closure of cranial sutures (primary craniosynostosis) in children leads to characteristics skull deformities and prevents the constricted brain from growing normally. Although the cause remains unknown, several etiological factors have been cited. Recently, hypovascularity has been reported as a possible cause of craniosynostosis. Methods: In a prospective study regional cerebral blood flow studies were carried out with ^99mTc-HMPAO SPECT in seven children with craniosynostoses. Five preoperative and six postoperative studies were conducted and the results correlated with radiological and surgical findings. Results: Preoperative studies revealed regional hypovascularity in the underlying cerebral hemisphere, corresponding to the fused sutures. Postoperative studies revealed disappearance of these perfusion defects in most cases, indicating normalization of perfusion following surgical decompression. Conclusion: This study establishes the presence of cerebral hypovascularity in craniosynostoses and suggests that early surgery and release of craniostenosis is essential to achieve optimum perfusion and brain development.

Key Words: technetium-99m-HMPAO • brain SPECT • regional cerebral blood flow • craniosynostosis

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