UNLABELLED: We prospectively evaluated the contribution of 99mTc-HMPAO SPECT in patients who have sustained acute, mild or moderate head trauma. METHODS: Forty-two patients formed the first subgroup of moderate trauma (ModTr) and 25 patients formed the second subgroup of mild trauma (MilTr). All 67 patients underwent an initial SPECT (Tinit) within 4 wk after a closed cranial trauma. After a mean interval of 3 mo from the time of Tinit, all patients were clinically re-evaluated; those with an abnormal Tinit underwent a repeat SPECT (Trpt) as well. All SPECT studies were visually graded by agreement of three observers adjudging a score ranging from 0 (no lesions) to 4. RESULTS: For the group as a whole (ModTr + MilTr), the following results could be derived: (1) in 32/33 Tinit negative cases, clinical symptoms had resolved; (2) the positive predictive value of Tinit was only 20/34 (59%); (3) the sensitivity for the repeat SPECT was 19/20 (95%). CONCLUSION: Our results show that: (1) SPECT alterations correlate well with the severity of the trauma; (2) a negative initial SPECT study is a reliable predictor of a favorable clinical outcome; (3) in cases with a positive initial SPECT, a follow-up consisting of a combination of SPECT and clinical data is necessary; (4) in patients suffering from postconclusive symptoms, SPECT offers an instrument to objective sequelae.
UNLABELLED: We prospectively evaluated the contribution of 99mTc-HMPAO SPECT in patients who have sustained acute, mild or moderate head trauma. METHODS: Forty-two patients formed the first subgroup of moderate trauma (ModTr) and 25 patients formed the second subgroup of mild trauma (MilTr). All 67 patients underwent an initial SPECT (Tinit) within 4 wk after a closed cranial trauma. After a mean interval of 3 mo from the time of Tinit, all patients were clinically re-evaluated; those with an abnormal Tinit underwent a repeat SPECT (Trpt) as well. All SPECT studies were visually graded by agreement of three observers adjudging a score ranging from 0 (no lesions) to 4. RESULTS: For the group as a whole (ModTr + MilTr), the following results could be derived: (1) in 32/33 Tinit negative cases, clinical symptoms had resolved; (2) the positive predictive value of Tinit was only 20/34 (59%); (3) the sensitivity for the repeat SPECT was 19/20 (95%). CONCLUSION: Our results show that: (1) SPECT alterations correlate well with the severity of the trauma; (2) a negative initial SPECT study is a reliable predictor of a favorable clinical outcome; (3) in cases with a positive initial SPECT, a follow-up consisting of a combination of SPECT and clinical data is necessary; (4) in patients suffering from postconclusive symptoms, SPECT offers an instrument to objective sequelae.
Authors: Franck Amyot; David B Arciniegas; Michael P Brazaitis; Kenneth C Curley; Ramon Diaz-Arrastia; Amir Gandjbakhche; Peter Herscovitch; Sidney R Hinds; Geoffrey T Manley; Anthony Pacifico; Alexander Razumovsky; Jason Riley; Wanda Salzer; Robert Shih; James G Smirniotopoulos; Derek Stocker Journal: J Neurotrauma Date: 2015-09-30 Impact factor: 5.269
Authors: H M Jansen; J van der Naalt; A H van Zomeren; A M Paans; L Veenma-van der Duin; J M Hew; J Pruim; J M Minderhoud; J Korf Journal: J Neurol Neurosurg Psychiatry Date: 1996-02 Impact factor: 10.154
Authors: B P Radanov; I Bicik; J Dvorak; J Antinnes; G K von Schulthess; A Buck Journal: J Neurol Neurosurg Psychiatry Date: 1999-04 Impact factor: 10.154
Authors: N K Gowda; D Agrawal; C Bal; N Chandrashekar; M Tripati; G P Bandopadhyaya; A Malhotra; A K Mahapatra Journal: AJNR Am J Neuroradiol Date: 2006-02 Impact factor: 3.825