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Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease

We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal...

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Autores principales: Vicente, Justo Serrano, Prudencio, Luis Fernández, Torre, José Rafael Infante, Madrid, Juan Ignacio Rayo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5883438/
https://www.ncbi.nlm.nih.gov/pubmed/29643681
http://dx.doi.org/10.4103/ijnm.IJNM_2_18
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author Vicente, Justo Serrano
Prudencio, Luis Fernández
Torre, José Rafael Infante
Madrid, Juan Ignacio Rayo
author_facet Vicente, Justo Serrano
Prudencio, Luis Fernández
Torre, José Rafael Infante
Madrid, Juan Ignacio Rayo
author_sort Vicente, Justo Serrano
collection PubMed
description We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal carotid and main intracranial arteries with plenty collateral vessels with “puff of smoke” suggesting a moyamoya disease (MMD). Brain perfusion single-photon emission CT showed global diminished perfusion in the brain lobes and a marked relative hyperperfusion in the cerebellum. However, brain (18)F-fluorodeoxyglucose-positron emission tomography showed physiological metabolism in the brain cortex with only slightly relative cerebellar hypermetabolism. MMD is a well-known arterial pathology that frequently develops with only mild symptoms until the middle age. Functional neuroimaging findings indicate a mismatch between brain glucose metabolism and brain perfusion, probably due to neuronal subclinical chronic ischemia in the brain cortex with preserved viability of neurons.
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spelling pubmed-58834382018-04-11 Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease Vicente, Justo Serrano Prudencio, Luis Fernández Torre, José Rafael Infante Madrid, Juan Ignacio Rayo Indian J Nucl Med Case Report We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal carotid and main intracranial arteries with plenty collateral vessels with “puff of smoke” suggesting a moyamoya disease (MMD). Brain perfusion single-photon emission CT showed global diminished perfusion in the brain lobes and a marked relative hyperperfusion in the cerebellum. However, brain (18)F-fluorodeoxyglucose-positron emission tomography showed physiological metabolism in the brain cortex with only slightly relative cerebellar hypermetabolism. MMD is a well-known arterial pathology that frequently develops with only mild symptoms until the middle age. Functional neuroimaging findings indicate a mismatch between brain glucose metabolism and brain perfusion, probably due to neuronal subclinical chronic ischemia in the brain cortex with preserved viability of neurons. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5883438/ /pubmed/29643681 http://dx.doi.org/10.4103/ijnm.IJNM_2_18 Text en Copyright: © 2018 Indian Journal of Nuclear Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Vicente, Justo Serrano
Prudencio, Luis Fernández
Torre, José Rafael Infante
Madrid, Juan Ignacio Rayo
Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease
title Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease
title_full Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease
title_fullStr Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease
title_full_unstemmed Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease
title_short Mismatch in Brain Perfusion and Metabolism Detected with (99m)Tc-Hexamethyl Propylene Amine Oxime Single Photon Emission Computed Tomography and (18)F-Fluorodeoxyglucose Positron Emission Tomography in Moyamoya Disease
title_sort mismatch in brain perfusion and metabolism detected with (99m)tc-hexamethyl propylene amine oxime single photon emission computed tomography and (18)f-fluorodeoxyglucose positron emission tomography in moyamoya disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5883438/
https://www.ncbi.nlm.nih.gov/pubmed/29643681
http://dx.doi.org/10.4103/ijnm.IJNM_2_18
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