Brain perfusion scan Case report Case Ⅰ Name: 鄭 XX Sex: female Age: 13 y/o Date: 89/8/1~89/10/7.

Brain perfusion scan

Case report

Case Ⅰ

• Name: 鄭 XX

• Sex: female

• Age: 13 y/o

• Date: 89/8/1~89/10/7

Chief complaint

• traffic accident on 2000/5/30

Present illness

• this 13 y/o female is a victim of :

• 1. head injury with right frontal-temporal-parietal hemorrhage, SAH, skull fracture, severe brain edema s/p right craniectomy on 2000/5/30 in 邱綜合 hospital.

• 2. hydrocephalus s/p V-P shunt on 2000/6/12.

• So far, the GCS: E2VtM4.

• Fever and seizure has been noted during the past 1 week.

Now she was admitted to our ward to have further care.

• Physical examination

• Conscious: E2VtM4

• Others: np

• NE: ?

Impression:

• hydrocephalus s/p V-P shunt

• Head injury with ICH post OP; with skull fracture

• Fever, R/o lung, urinary, CNS infection

Plan:

• F/U brain CT

• Survey for infection sign

• Antibiotics

Date: 90/1/2

• C.C: skull defect

PI :

• 1. HI with ICH post op

• 2. hydrocephalus post op

• 3. Bilateral traumatic optic nerve atrophy

• 4. skull defect

• This time she was admitted to our NS ward for surgery of cranioplasty for her skull defect

• 90/1/3: Tc-99m HMPAO brain perfusion SPECT

Case Ⅱ

• Name: 林 XX

• Sex: male

• Age: 72 y/o

• Date: 90/1/1~901/11

Chief complaint

• blurred vision(ou) noted for one week and bilateral temporal area headache and slow movement noted recent two days(subacute onset)

Present illness

• this 72 y/o male was a case of 1.DM, 2.H/T

• He suffered from blurred vision(ou) for 1 week and bil temporal area headache and slow movement in recent 2 days (subcute onset)

• slightly progressive associated symptoms: left side drooling, and bilateral hand tremor(+)

• So he went to our ER for help

• brain CT revealed: hypodensity without obvious enhancement over right temporal, occipital lobe with edema and lateral ventricle compression, mid-line shift.

NE: left mild central facial palsy

• Impression:

• 1. CVD

• 2. R/O brain tumor

• 90/1/8: Tc-99m HMPAO brain perfusion SPECT

Tc99m HMPAO brain perfusion scan ＆ SPECT

• Indication: cerebral infarction, cerebral hemorrhage, TIA, cerebral ischemia, Alzheimer’s disease, senile dementia, multiple infarct dementia, head injury, epilepsy, encephalitis, convulsion disorder, Parkinson’s disease