Biomedical subjects

Mordechai Lorberboym

Publications and source records attributed to Mordechai Lorberboym.

22 records · Page 2Linked to original sources

PubMed2002

Brain SPECT evaluation of amnestic ED patients after mild head trauma.

A short period of amnesia is a common complaint after mild head injury. In this study we compare the duration of amnesia after mild head trauma to single photon emission computed tomography (SPECT) perfusion imaging shortly after admission to the emergency department (ED). Sixteen patients consecutively admitted to the ED were prospectively evaluated. The amnesia was scored according to the Extended Glasgow Coma Score. A computed tomography (CT) scan was performed to all patients. All patients had anterograde amnesia. Eleven patients had amnesia of grade 2 (69%) and 5 patients of grade 3 (31%). All patients had a normal CT scan. Twelve of sixteen patients (75%) showed regional perfusion abnormalities on the SPECT study. Decreased perfusion was observed at least in one region (8/12 patients had 2 abnormal regions). The logistic regression analysis showed that SPECT results significantly predicted the severity of amnesia (r = 0.9, P <.0001). Additionally, the SPECT accounted for approximately 84% of the variation in amnesia. We conclude that amnesia after mild head injury is associated with a high incidence of early regional cerebral perfusion abnormalities. Amnesia lasting more than half an hour is associated with bilateral cerebral hypoperfusion. SPECT evaluation in the ED may by a useful additional tool in the objective assessment of posttraumatic amnesia.

Adolescent↗

PubMed2002

Decreased sternal vascularity after internal thoracic artery harvesting resolves with time: an assessment with single photon emission computed tomography.

OBJECTIVE: We sought to prospectively evaluate the long-term effect of left internal thoracic artery harvesting on sternal vascularity. METHODS: Twelve consecutive patients undergoing primary coronary artery bypass grafting were studied. In all patients a pedicled left internal thoracic artery was harvested. Each patient underwent a preoperative technetium-99m methylene diphosphonate bone scan with single photon emission computed tomography. The ratio of the mean counts per pixel for each side of the sternum was obtained. All patients had early repeat bone scans 6 plus minus 2.4 days postoperatively and late repeat bone scans 18.6 plus minus 3.5 months after the operation. Ratios of unilateral sternal uptakes were compared between the different scans. One patient died during follow-up and was excluded from the study. RESULTS: There was a significant decrease in flow to the left hemisternum in the early postoperative scan compared with that in the preoperative scan (P <.001). At late follow-up scans, flow to the left hemisternum had returned to normal (P =.119). Midterm clinical follow-up demonstrated 3 superficial wound infections. No musculoskeletal pain existed at the time of follow-up, but 3 patients had numbness or tingling at the skin area corresponding to the site from which the left internal thoracic artery was harvested. CONCLUSIONS: Acute postoperative sternal ischemia caused by harvesting of a pedicled left internal thoracic artery is temporary and resolves with time.

Aged↗

PubMed2002

Tc-99m ethylcysteinate dimer brain SPECT perfusion imaging in ictal nonepileptic visual hallucinations.

PURPOSE: Visual hallucinations can occur within the central nervous system and may be associated with a lesion anywhere in the visual pathway. The purpose of this study was to assess "ictal" regional cerebral blood flow with Tc-99m ethylcysteinate dimer (ECD) SPECT in patients having acute hallucinations, and to compare the findings to the "interictal" state. METHODS: A prospective study was performed to evaluate patients admitted to the neurology department with nonpsychiatric and nonepileptic visual hallucinations. The nine patients included in the study underwent thorough neurologic and psychiatric evaluations. A computed tomographic (CT) scan was performed when each patient was admitted, and electroencephalographic (EEG) recordings were made during their hallucinations. All patients underwent a brain SPECT while having acute hallucinations (ictal SPECT), and a follow-up scan was obtained 2 to 3 weeks later. RESULTS: All patients had normal ictal EEG findings during the hallucinations. Seven of nine patients had increased perfusion on the SPECT studies in one or more regions, with a mean lesion-to-contralateral ratio of 2.1 (range, 1.5 to 2.7). Three of the seven patients had findings consistent with a cerebrovascular accident. After treatment, the hallucinations disappeared in two patients and the motor deficit improved dramatically. The follow-up SPECT study showed significant improvement in all patients 1 week later. Charles Bonnet syndrome, frontal lobe dementia, and Anton syndrome were diagnosed in three other patients, and the last one had no identifiable background disease, all with normal findings of EEG, CT, and magnetic resonance examinations. They all responded readily to carbamazepine therapy, and the follow-up SPECT study showed resolution of the findings. Two of nine patients showed posterior cortical hypoperfusion, and eventually Lewy body disease was diagnosed. The SPECT showed no evidence of regional hyperperfusion. CONCLUSIONS: This prospective preliminary study suggests that brain imaging using SPECT may be useful in identifying the mechanisms and evolution of blood flow abnormalities in certain subgroups of patients who have visual hallucinations and may assist in the selection of specific therapy.

Aged↗

PubMed2002

Late whiplash syndrome: correlation of brain SPECT with neuropsychological tests and P300 event-related potential.

BACKGROUND: The acceleration forces infringing the cervical spine in whiplash injury are frequently associated with multiple cerebral symptoms. The purpose of this study was to determine whether there is a correlation between cerebral perfusion findings, P300 recording (an electrophysiologic marker of cognitive ability), and neuropsychological tests in patients with whiplash injury. METHODS: Twenty patients with chronic whiplash injury underwent extensive clinical evaluation and neuropsychological testing. A brain single-photon emission computed tomography (SPECT) study using 99mTc-HMPAO was performed in all patients within 24 hours of neuropsychological evaluation. P300 event-related potentials were performed in 15 patients and in 9 normal volunteers. RESULTS: Thirteen of 20 patients had brain perfusion abnormalities on the SPECT studies, in one or more regions. Eight of 15 patients had abnormal P300 studies. Seven of eight patients with abnormal P300 had also an abnormal SPECT study. Seven of 15 patients had normal P300 results, 6 of them with a normal SPECT and 1 with SPECT abnormalities. There was no significant correlation between the SPECT findings or the P300 results and the scores of attention and working memory. There was, however, close agreement between the SPECT and P300. CONCLUSION: SPECT perfusion abnormalities in patients with chronic whiplash syndrome correlate well with P300 recording. The combination of these studies with neurocognitive and neurobehavioral tests may be useful in identifying a subgroup of patients having organic brain lesions.

Adult↗