RESUMO
BACKGROUND: Diffusion weighted magnetic resonance imaging (DWI) and single photon emission computed tomography (SPECT) can demonstrate ischemic brain injury within the first several hours after the onset of symptoms. We investigated the utility of combined DWI and SPECT in the assessment of acute cerebral infarction. METHODS: Nineteen patients with acute middle cerebral artery territory infarction underwent DWI and SPECT within 12 hours of symptom onset (mean, 9.6 hour). In SPECT, we defined abnormality as a perfusion defect region (perfusion ??30% compared to a normal cortex) and an ischemic region (perfusion difference ??10% compared to a contralateral normal hemisphere). The initial DWI and SPECT lesion volume ratios (lesion volume / hemispheric volume) were analyzed with subsequent neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI). RESULTS: There was a high correlation between clinical scores within 7 days and lesion volumes determined by DWI and SPECT respectively (p<0.05). The lesion volumes detected by DWI and SPECT significantly correlated with each other (p<0.01). Ischemic lesions on SPECT were larger in the group (n=10) with ICA occlusions than in the other group (p=0.034). In 15 patients with cortical lesions, the ratio of perfusion defect volumes on SPECT to lesion volumes on DWI was higher in the group with favorable outcome than in the group with unfavorable outcome (p=0.01). CONCLUSIONS: Both DWI and SPECT are highly correlated with the severity of neurological deficit in acute cerebral infarction. Furthermore, combined use of DWI and SPECT would be more powerful than either study alone in predicting clinical outcome. (J Korean Neurol Assoc 19(2):88~95, 2001)
Assuntos
Humanos , Lesões Encefálicas , Infarto Cerebral , Imagem de Difusão por Ressonância Magnética , Difusão , Infarto , Imageamento por Ressonância Magnética , Artéria Cerebral Média , Perfusão , Acidente Vascular Cerebral , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
BACKGROUND: Diffusion weighted magnetic resonance imaging (DWI) and single photon emission computed tomography (SPECT) can demonstrate ischemic brain injury within the first several hours after the onset of symptoms. We investigated the utility of combined DWI and SPECT in the assessment of acute cerebral infarction. METHODS: Nineteen patients with acute middle cerebral artery territory infarction underwent DWI and SPECT within 12 hours of symptom onset (mean, 9.6 hour). In SPECT, we defined abnormality as a perfusion defect region (perfusion ??30% compared to a normal cortex) and an ischemic region (perfusion difference ??10% compared to a contralateral normal hemisphere). The initial DWI and SPECT lesion volume ratios (lesion volume / hemispheric volume) were analyzed with subsequent neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI). RESULTS: There was a high correlation between clinical scores within 7 days and lesion volumes determined by DWI and SPECT respectively (p<0.05). The lesion volumes detected by DWI and SPECT significantly correlated with each other (p<0.01). Ischemic lesions on SPECT were larger in the group (n=10) with ICA occlusions than in the other group (p=0.034). In 15 patients with cortical lesions, the ratio of perfusion defect volumes on SPECT to lesion volumes on DWI was higher in the group with favorable outcome than in the group with unfavorable outcome (p=0.01). CONCLUSIONS: Both DWI and SPECT are highly correlated with the severity of neurological deficit in acute cerebral infarction. Furthermore, combined use of DWI and SPECT would be more powerful than either study alone in predicting clinical outcome. (J Korean Neurol Assoc 19(2):88~95, 2001)
Assuntos
Humanos , Lesões Encefálicas , Infarto Cerebral , Imagem de Difusão por Ressonância Magnética , Difusão , Infarto , Imageamento por Ressonância Magnética , Artéria Cerebral Média , Perfusão , Acidente Vascular Cerebral , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
PURPOSE: Patients with epilepsy experience the impairment of Quality of life (QOL). The objective of this study was to investigate the 'Quality of Life' in epileptic patients and the influences of clinical factors upon QOL in epileptic patients. METHODS: Total 138 epileptic patients (male : 77, female : 61) were recruited for the study. The Quality of Life in Epilepsy (QOLIE)-89 was applied to evaluate QOL in epileptic patients. We gathered data about clinical variables (seizure type, frequency, duration of disease, number of antiepileptic drug, and depression) and socio-demographic variables (age, sex, marriage, employment, and education), and compared each variables in use of QOLIE-89 score. RESULTS: Depression influenced negatively the most of all subscales (16 of 20 subscales) and overall score (p or =16 year) had higher score at overall score and emotional well-being (p<0.05). However, age, marital state, employment, seizure type, and duration of disease did not affect QOL significantly. CONCLUSIONS: Sex, education, number of AEDs, depression, and seizure free state were major socio-clinical factors affecting QOL in patients with epilepsy. It is suggested that physician should recognize these factors and manage appropriately for improving the QOL.