¹²³I–iomazenil SPECT集積低下と慢性期の脳萎縮の一致を認めた乳児急性硬膜下血腫の2例

抄録

Diffuse hemispheric ischemic changes are often confirmed in cases of infantile acute subdural hematoma in acute phase, and diffuse brain atrophy was also confirmed in chronic phase. This atrophy is often confirmed in cases where abnormal findings were not confirmed on brain CT or MRI in acute phase. ¹²³I-iomazenil SPECT findings in two cases of acute subdural hematoma were compared with CT findings in these cases in chronic phase.

Case 1 (9-month-old boy) required craniotomy for left acute subdural hematoma, showed left hemispheric diffuse low density on CT on the 4th hospital day, and showed left hemispheric high signal and no abnormal findings in the right hemisphere on diffusion-weighted MRI on the 6th hospital day. ¹²³I-iomazenil SPECT on day 31 showed reduced uptake in the whole left hemisphere and right frontal lobe, which was matched to brain atrophy on CT in chronic phase. Case 2 (8-month-old boy) required craniotomy for left acute subdural hematoma, showed left hemispheric diffuse low density on CT on the 4th hospital day, and showed left hemispheric high signal and slightly elevated signal in the right hemisphere on diffusion-weighted MRI on the 3rd hospital day. ¹²³I-iomazenil SPECT on the 4th day showed uptake reduction in the whole left hemisphere and right frontal lobe, which were matched to brain atrophy on CT in chronic phase.

In conclusion, reduction of ¹²³I-iomazenil uptake with SPECT in two cases of infantile acute subdural hematoma was matched to brain atrophy in these cases in chronic phase. ¹²³I-iomazenil SPECT may predict prospective brain atrophy more accurately than conventional CT and MRI.