High-resolution nuclear magnetic resonance imaging and single photon emission computerized tomography--cerebral blood flow in a case of pure sensory stroke and mild dementia owing to subcortical arteriosclerotic encephalopathy (Binswanger's disease)

Journal Article · Thu Jan 01 04:00:00 EST 1987 · Am. J. Physiol. Imag.; (United States)

OSTI ID:6840673

De Chiara, S; Lassen, N A; Andersen, A R; Gade, A; Lester, J; Thomsen, C; Henriksen, O

Pure sensory stroke (PSS) is typically caused by a lacunar infarct located in the ventral-posterior (VP) thalamic nucleus contralateral to the paresthetic symptoms. The lesion is usually so small that it cannot be seen on computerized tomography (CT), as illustrated by our case. In our moderately hypertensive, 72-year-old patient with PSS, CT scanning and conventional nuclear magnetic resonance imaging (NMRI) scanning using a 7-mm-thick slice on a 1.5 Tesla instrument all failed to visualize the thalamic infarct. Using the high-resolution mode with 2-mm slice thickness it was, however, clearly seen. In addition, NMRI unexpectedly showed diffuse periventricular demyelinization as well as three other lacunar infarcts, i.e., findings characteristic of subcortical arteriosclerotic encephalopathy (SAE). This prompted psychometric testing, which revealed signs of mild (subclinical) dementia, in particular involving visiospatial apraxia; this pointed to decreased function of the right parietal cortex, which was structurally intact on CT and NMRI. Single photon emission computerized tomography by Xenon-133 injection and by hexamethyl-propyleneamine-oxim labeled with Technetium-99m showed asymmetric distribution of cerebral blood flow (CBF), with an 18% lower value in the right parietal cortex compared to the left side; this indicated asymmetric disconnection of the cortex by the SAE. Thus, the tomograms of the functional parameter, CBF, correlated better with the deficits revealed by neuropsychological testing than by CT or NMRI.

• Research Organization: Bispebjerg Hospital (Denmark)
• OSTI ID: 6840673
• Journal Information: Am. J. Physiol. Imag.; (United States), Journal Name: Am. J. Physiol. Imag.; (United States) Vol. 2:4; ISSN AJPIE
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
AMINES
ARTERIOSCLEROSIS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD FLOW
BODY
BRAIN
CARDIOVASCULAR DISEASES
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
EMISSION COMPUTED TOMOGRAPHY
EVEN-ODD NUCLEI
HOURS LIVING RADIOISOTOPES
HYDROXY COMPOUNDS
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
NERVOUS SYSTEM
NMR IMAGING
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANOMETALLIC COMPOUNDS
ORGANS
OXIMES
PATIENTS
RADIOISOTOPES
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
TECHNETIUM 99
TECHNETIUM ISOTOPES
TOMOGRAPHY
TRACER TECHNIQUES
VASCULAR DISEASES
XENON 133
XENON ISOTOPES
YEARS LIVING RADIOISOTOPES