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Cerebral Hemodynamics and Metabolism of Severe Diffuse Brain Injury Measured by PET

Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

Correspondence: For correspondence reprints contact: Tarumi Yamaki, MD, Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, 602, Japan.

ABSTRACT

Cerebral hemodynamics and metabolism in three patients with severe diffuse brain injury were measured 10 days after onset using PET. In this study, regional cerebral blood flow (rCBF), oxygen extraction fraction (rOEF), cerebral blood volume (rCBV),cerebral metabolic rate for oxygen (rCMRO2), cerebral metabolic rate for glucose (rCMRglc)and cerebral metabolic ratio (rCMRO2/rCMRglc) were measured. The Glasgow Coma Scale scores on admission were 4, 5 and 5, respectively, and CT on admission showed typical findings of diffuse brain injury. As a result, PET revealed misery perfusion and hyperglycotysis in Patient 1 and matching low perfusion and low glucose metabolism in Patients 2 and 3. Although Patient 1 died, Patients 2 and 3 had good recoveries. We speculate that a long-lasting anaerobic state, indicated by a high OEF value and low metabolic ratio, is an important undesirable factor related to the outcome.

Key Words: diffuse brain injury cerebral blood flow and metabolism • PET

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