Three dimentional analyses of local cerebral blood flow (ICBF) and pool (ICBP) were done in 26 patients with ruptured intracranial aneurysms. The sites of the aneurysms were as follows: 4 in the internal carotid, 12 in the anterior communicating, 8 in the middle cerebral, and two in the vertebral arteries. The serial changes of ICBF, ICBP under various pathophysiological conditions were analyzed. LCBF was obtained by 133Xe inhalation method and ICBF by 99mTc-HSA (human serum albumin) injection method.
The results were as follows:
1) Reduction of ICBF and uptake of 99mTc-HSA produced by surgical procedures were localized and recovered in a few weeks.
2) Mild reduction (20-30%) of ICBF in general was recognized even in the patients without vasospasm postoperatively.
3) Only mild reduction of ICBF without uptake of 99mTc-HSA showed good prognosis for the patients.
4) Severe reduction of ICBF with high uptake of 99mTc-HSA in the acute phase showed poor prognosis for the patients. And they often associated with global cerebral infarction or hemorrhagic infarction in the subacute phase.
5) SPECT study under induced hypertention treatment with dopamine HCI infusion in the patients with vasospasm revealed heterogeneously disturbed areas of autoregulation of the cerebral blood flow depending on cases and sites of the lesion.
Three dimentional analyses of local cerebral blood flow and pool were useful to detect the pathophysiology after ruptured intracranial aneurysm and to deside the adequate therapy for patients.
