VOLUME OF INFARCTION AND BLOOD-FLOW IN CEREBRAL EMBOLISM

The value of measuring asymmetry of cerebral perfusion semiquantitativ ely by single-photon emission computed tomography (SPECT) correlated w ith measuring the volume of infarction on computed tomography (CT) was evaluated in cerebral embolism. Eighteen patients with acute cerebral embolism (mean age: sixty-nine years) were evaluated. Ten were diagno sed as having middle cerebral artery (MCA) occlusion, 3 as having MCA branch occlusion, and 4 as having unilateral and 1 as having bilateral internal carotid occlusion. The infarct volume was measured, summing up the area of infarction on CT, at 8.5 days, mean time after onset. O utcomes of the patients were classified into three groups: good, fair, or dead, judged by the consequences one month after onset. Regional c erebral blood flow (rCBF) was measured in 9 of 10 surviving patients a t one month, mean time after onset, by (123)Iodine N-isopropyl-p-iodoa mphetamine (IMP) SPECT. Semiquantitative rCBF index of asymmetry (Al) was evaluated from four regions of brain cortex. Eleven patients with <300 mL infarct and 7 with greater than or equal to 300 mi, infarct sh owed a significant difference of outcome with infarct volumes (P < 0.0 1). The mean Al value in patients with <150 mi, infarct was 31% while it was 52% with greater than or equal to 150 mt infarct (P < 0.039). T here were significant linear correlations between mean Al values and t he volumes of infarction or infarct/brain volume ratios (P < 0.034 or P < 0.018). The significant correlations of the AI values with the vol umes of infarction suggest that the measured asymmetry of perfusion ev aluated by SPECT could reflect the ultimate tissue damage and residual intact brain volume after cerebral embolism.