NORMAL HIGH-RESOLUTION CEREBRAL TC-99M-HMPAO SPECT SCANS IN SYMPTOMATIC NEONATES EXPOSED TO COCAINE

Vascular constriction is said to account for a variety of clinical eff ects of cocaine. High-resolution Tc-99m-hexamethylpropylene amine oxim e single photon emission computed tomographic (SPECT) scans, which mea sure cerebral blood flow, were used to determine whether neonatal brai n perfusion deficits are present in newborns with confirmed cocaine ex posure. Normal, age-appropriate SPECT scans were found in 21 babies. C onventional neuroimaging was also performed when possible. Ail but one of the 14 magnetic resonance imaging (MRI) scans and one computed tom ographic scan were normal. One MRI showed a mild delay in myelination. All but four neonates had behavioral or electroencephalographic abnor malities, and microcephaly was found in five of 21. The normal neonata l SPECT scans contrast with findings in adult cocaine users, which typ ically report abnormal findings of cerebral hypoperfusion. This study identifies a unique lack of corresponding cerebral vascular pathology in symptomatic neonates. It raises the possibility that many of these children can escape significant ischemic injury.