Sztriha L, al Suhaili A R, Prais V, Nork M
Department of Paediatries, FMHS, UAE University, Al Ain, United Arab Emirates.
Neuropediatrics. 1996 Aug;27(4):178-83. doi: 10.1055/s-2007-973783.
Fourteen children with spastic hemiplegia of various etiology: cerebral palsy (seven cases, five with porencephalic cyst); stroke with small deep infarcts (two); hemiconvulsion-hemiplegia-epilepsy syndrome (three); traumatic brain injury (two), were investigated by 99mTc-HMPAO SPECT. Localized and remote perfusion abnormalities were studied. Hypoperfusion corresponding to CT abnormalities was found in each group, but the perfusion deficit extended beyond the boundaries of anatomical defects, most prominently in cases with widespread unilateral epileptic discharges. Ipsilateral cerebellar diaschisis was observed in patients with early cerebral insult (who had porencephalic cyst of pre- or perinatal onset) and crossed cerebellar diaschisis was noted in a patient who sustained traumatic brain injury at a later age. Diaschisis in the overlying cortex, thalamus and basal ganglia was noticed in several cases. Although clinical symptoms or signs could not be unequivocally attributed either to the size of the perfusion defects beyond the boundaries of lesions shown by CT or to the diaschisis, the findings may contribute to reveal age-related abnormal perfusion patterns.
对14名患有各种病因所致痉挛性偏瘫的儿童进行了99mTc-HMPAO单光子发射计算机断层扫描（SPECT）检查，这些病因包括：脑瘫（7例，其中5例伴有脑穿通畸形囊肿）；伴有小的深部梗死灶的中风（2例）；偏瘫型惊厥-偏瘫-癫痫综合征（3例）；创伤性脑损伤（2例）。研究了局部和远隔灌注异常情况。在每组中均发现了与CT异常相对应的灌注减低，但灌注缺损超出了解剖学缺陷的边界，在广泛单侧癫痫放电的病例中最为明显。在早期脑损伤（产前或围产期发病的脑穿通畸形囊肿）患者中观察到同侧小脑失联络，在较晚年龄遭受创伤性脑损伤的一名患者中发现了交叉性小脑失联络。在几例病例中还注意到了大脑皮质、丘脑和基底节的失联络。尽管临床症状或体征不能明确归因于CT所示病变边界之外的灌注缺损大小或失联络，但这些发现可能有助于揭示与年龄相关的异常灌注模式。
