SPECT WITH TECHNETIUM-99M-HMPAO IN RELATION TO LATE COGNITIVE OUTCOMEAFTER SURGERY FOR RUPTURED CEREBRAL ANEURYSMS

Fifteen patients with a good neurological outcome after aneurysmal SAH and surgery were collected prospectively. Six months after surgery ne urological examination and a SPECT study for evaluation of the three d imensional CBF distribution as well as an extensive neuropsychological test were performed. In all patients with pathological SPECT findings the location of the reduced regional CBF correlated with the location of the ruptured aneurysm and/or side of surgical approach. The volume of the brain tissue with reduced rCBF showed a great variety, from 9- 112 cm(3) (mean: 33 cm(3)). Similarly, the maximum flow reduction in t he affected areas also varied considerably from 17-95% (mean: 39%). In general, the neuropsychological functioning of the patients post SAH was favourable. Seven individuals had a presumably normal neuropsychol ogical appearance with respect to estimates of premorbid levels of fun ctioning. Another four patients were slightly impaired and the remaini ng four were moderately affected. Only in five cases did the location of SPECT pathology and the site of neuropsychological impairment appea r to coincide, whereas this was not the case in the remaining 10 patie nts. In general, the extent of SPECT pathology did not differ in the t hree neuropsychological outcome groups (normal, slight and moderate di sability).