• Neurol. Med. Chir. (Tokyo) · Aug 2008

    Diffusion-perfusion mismatch in symptomatic vasospasm after subarachnoid hemorrhage.

    • Tatsuya Ohtonari, Kenichi Kakinuma, Tomohiro Kito, Isamu Ezuka, and Tsutomu Kanazawa.
    • Department of Neurosurgery, Cerebrovascular Center, Niigata Rosai Hospital, Joetsu, Japan. otonari1@alpha.ocn.ne.jp
    • Neurol. Med. Chir. (Tokyo). 2008 Aug 1; 48 (8): 331-6; discussion 336.

    AbstractDiffusion-weighted and perfusion-weighted magnetic resonance (MR) imaging were investigated as a method to detect diffusion-perfusion mismatch in the early stages of vasospasm in 17 patients with acute subarachnoid hemorrhage after aneurysm clipping. Single photon emission computed tomography (SPECT) with N-isopropyl-p-[(123)I]iodoamphetamine was also performed. Diffusion-perfusion mismatch was clearly identified in the 3 patients who manifested clinical deterioration. Perfusion-weighted imaging showed increased mean transit time, normal cerebral blood flow, and increased or normal cerebral blood volume. SPECT revealed no earlier signs of vasospasm. Diffusion-perfusion mismatch was clearly demonstrated in the early stages of vasospasm, so may be useful for early identification of ischemia in vasospasm and initiating appropriate treatment.

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