Classification of acute ischemic stroke in the elderly by single photon emission computed tomography using 99mTc-hexamethyl-propylene-amine-oxime. For management of acute stroke

We evaluated the usefulness of single photon emission computed tomography (SPECT) using 99mTc-hexamethyl-propylene-amine-oxime (HMPAO) for classification of the stroke subtype in elderly patients with acute ischemic stroke. The association between the asymmetric index (AI) calculated from the HMPAO SPECT findings on admission and the diagnosed stroke subtype on discharge in 47 cases with supratentorial cerebral infarction (mean age±1 SD, 78.7±7.8 years; cerebral embolism, 19 cases; cerebral thrombosis, 28 cases) was studied retrospectively. The AI was determined as the percentage of decreased radioactivity in the ischemic lesion with respect to the symmetrical region in the contralateral hemisphere. The values were significantly higher in the embolic group than in the thrombotic group (means±1 SD): embolic group, 51.7±16.3%; thrombotic group, 19.0±10.0%), and classification was possible. This finding suggests that noninvasive HMPAO SPECT can be of value for classifying stroke subtype in aged patients with acute ischemic stroke. (author)