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Reversible Hypoperfusion of the Cerebral Cortex in Normal-Pressure Hydrocephalus on Technetium-99m-HMPAO Brain SPECT Images After Shunt Operation

Nuclear Medicine and Neurosurgery Service, Department of Veterans Affairs Medical Center; Lexington, Kentucky
Departments of Radiology and Surgery, University of Kentucky Chandler Medical Center, Lexington, Kentucky

Correspondence: For correspondence or reprints contact: Wei-Jen Shih, MD, Division of Nuclear Medicine, Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St., Lexington, KY 40536-0084.

ABSTRACT

A man with dementia underwent radionuclide cistemography to establish the diagnosis of communicating hydrocephalus. Technetium-99m-HMPAO brain SPECT images showed marked hypoperfusion of both posterior cerebral cortices and three-dimensional displays that demonstrated perfusion defects at both of the posterior parietotemporal regions. A successful ventriculoperitoneal shunt operation was performed. Five and one-half months later, repeat three-dimensional display showed that the perfusion defects had resolved and a repeat brain SPECT image showed marked improvement of the hypoperfusion. This concurred with postoperative clinical improvement. Technetium-99m-HMPAO brain SPECT, which provides objective documentation of clinical recovery after surgery, could be routinely used to evaluate patients with normal-pressure hydrocephalus.

Key Words: SPECT • ventriculoperitoneal shunt • three-dimensional display

This article has been cited by other articles:

				R. A. Hurley, W. G. Bradley Jr., H. T. Latifi, and K. H. Taber Normal Pressure Hydrocephalus: Significance of MRI in a Potentially Treatable Dementia J Neuropsychiatry Clin Neurosci, August 1, 1999; 11(3): 297 - 300. [Full Text]