TECHNETIUM-99M-HMPAO SPECT CEREBRAL BLOOD-FLOW STUDY IN CHILDREN WITHCRANIOSYNOSTOSIS

Premature closure of cranial sutures (primary craniosynostosis) in chi ldren leads to characteristic skull deformities and prevents the const ricted brain from growing normally. Although the cause remains unknown , several etiological factors have been cited. Recently, hypovasculari ty has been reported as a possible cause of craniosynostosis. Methods: In a prospective study regional cerebral blood flow studies were carr ied out with Tc-99m-HMPAO SPECT in seven children with craniosynostose s. Five preoperative and six postoperative studies were conducted and the results correlated with radiological and surgical findings. Result s: Preoperative studies revealed regional hypovascularity in the under lying cerebral hemisphere, corresponding to the fused sutures. Postope rative studies revealed disappearance of these perfusion defects in mo st cases, indicating normalization of perfusion following surgical dec ompression. Conclusion: This study establishes the presence of cerebra l hypovascularity in craniosynostoses and suggests that early surgery and release of craniostenosis is essential to achieve optimum perfusio n and brain development.