ABSTRACT
Hemiplegic migraine (HM) is an unusual type of migraine, with few cases reported in the literature. Unlike other types of migraine, aura HM presents accompanying motor deficit manifestations that do not last more than 24 hours. We report a 27-year-old man referred to us from the emergency department to carry out a cerebral perfusion SPECT with (99m)Tc-HMPAO. He presented with intense headache and motor weakness. The brain perfusion scan was performed before and after intravenous infusion with nimodipine and showed a significant change of cerebral blood flow, allowing early and correct diagnosis.
Subject(s)
Brain/diagnostic imaging , Migraine with Aura/diagnostic imaging , Perfusion Imaging , Technetium Tc 99m Exametazime , Adult , Brain/blood supply , Humans , Male , Migraine with Aura/pathology , Migraine with Aura/physiopathology , Tomography, Emission-Computed, Single-PhotonABSTRACT
BACKGROUND AND METHODS: To determine whether patients with no heart disease who develop dynamic left ventricular outflow obstruction (DLVOTO) during dobutamine echocardiography (DE) reproduce the phenomenon during exercise echocardiography (EE), DE and EE were performed in 78 patients (59 +/- 9 years) with effort angina and no alterations in SPECT. Thirty-eight (48.7%) patients had DLVOTO during DE and 15 (19.2%) during EE. This phenomenon during EE was reproducible in 39.4% of the patients with DLVOTO on DE, and 100% of the patients with DLVOTO during EE had it during DE. Independent factors predicting DLVOTO during EE were the LVOT diameter (OR 0.33 (0.14-0.74)) and the left ventricular (LV) mass index (OR 1.05 (1.01-1.08)). No cardiovascular events were noted after 26+/-3 months. The reproducibility of DLVOTO during EE in patients with unexplained angina and with DLVOTO on DE is associated with the size of the LVOT and the LV mass index. The long-term prognosis is excellent.
