Patient Benefit from Cerebrovascular Reserve Capacity Assessment using Brain SPECT and Hypercapnia

Czech version

Authors: P. Širůček ¹; O. Kraft ¹; T. Hrbáč ²; V. Kosek ³
Authors‘ workplace: Fakultní nemocnice Ostrava Klinika nukleární medicíny ¹; Fakultní nemocnice Ostrava Neurochirurgická klinika ²; Fakultní nemocnice Ostrava Oddělení ekonomiky a financí ³
Published in: Cesk Slov Neurol N 2011; 74/107(3): 299-311
Category: Original Paper

Overview

Aim:
To determine whether symptomatic patients after revascularization brain surgery with reduced cerebrovascular reserve capacity (CVRC) established by brain SPECT and hypercapnia improved in terms of clinical findings and to assess any differences in the incidence of recurrence of stroke or TIA in the patient group with pathological CVRC results treated conservatively or surgically.

Material and Methods:
CVRC using brain SPECT with hypercapnia test was performed in 64 patients. Patients were divided into 3 groups. The first consisted of 31 patients with normal CVRC, the second of 14 patients with pathological CVRC who were treated conservatively, and the third of 19 patients with pathological CVRC who underwent surgical revascularization of the brain.

Results:
Neurological findings improved in 8 of the 19 patients (42%) in Group 3. Stroke and TIA recurrence after surgery was assessed in terms of secondary prevention. One patient had intracerebral haemorrhage after surgery, another 18 patients had no stroke or TIA after surgery. In the group of non-surgically treated patients there was one patient with ipsilateral stroke, one with ipsilateral TIA, and two patients died of fatal stroke. If we compare disease-free survival (DSF) in the two groups of patients with and without surgery, then a statistically difference emerges at a level of p = 0.15.

Conclusion:
CVRC examination is able to help with the selection of patients with occlusive cerebrovascular disease for neurosurgical bypass surgery.

Key words:
cerebrovascular reserve capacity – brain SPECT – hypercapnia

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