Watershed ischemia demonstrated with acetazolamide enhanced Tc-99m HMPAO SPECT. 1994

P Bohdiewicz, and J E Juni
Nuclear Medicine Department, William Beaumont Hospital, Royal Oak, Michigan 48073-6769.

A 75-year-old man who had a small right parietal infarction 8 months earlier underwent baseline and acetazolamide enhanced Tc-99m hexamethylpropylene amineoxime brain SPECT imaging. The acetazolamide study demonstrated a bilaterally symmetric perfusion deficit posteriorly near the midline. The baseline study was essentially normal. This finding was felt to represent watershed ischemia at the junction of the anterior circulations (anterior cerebral and middle cerebral arteries) and the posterior circulation (posterior cerebral artery). Carotid arteriography subsequently demonstrated left subclavian steal syndrome with retrograde flow through the left vertebral artery.

UI MeSH Term Description Entries
D007091 Image Processing, Computer-Assisted A technique of inputting two-dimensional or three-dimensional images into a computer and then enhancing or analyzing the imagery into a form that is more useful to the human observer. Biomedical Image Processing,Computer-Assisted Image Processing,Digital Image Processing,Image Analysis, Computer-Assisted,Image Reconstruction,Medical Image Processing,Analysis, Computer-Assisted Image,Computer-Assisted Image Analysis,Computer Assisted Image Analysis,Computer Assisted Image Processing,Computer-Assisted Image Analyses,Image Analyses, Computer-Assisted,Image Analysis, Computer Assisted,Image Processing, Biomedical,Image Processing, Computer Assisted,Image Processing, Digital,Image Processing, Medical,Image Processings, Medical,Image Reconstructions,Medical Image Processings,Processing, Biomedical Image,Processing, Digital Image,Processing, Medical Image,Processings, Digital Image,Processings, Medical Image,Reconstruction, Image,Reconstructions, Image
D008297 Male Males
D010091 Oximes Compounds that contain the radical R2C Aldoximes,Hydroxyimino Compounds,Ketoxime,Ketoximes,Oxime,Compounds, Hydroxyimino
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D002533 Cerebral Angiography Radiography of the vascular system of the brain after injection of a contrast medium. Angiography, Cerebral,Angiographies, Cerebral,Cerebral Angiographies
D002545 Brain Ischemia Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION. Cerebral Ischemia,Ischemic Encephalopathy,Encephalopathy, Ischemic,Ischemia, Cerebral,Brain Ischemias,Cerebral Ischemias,Ischemia, Brain,Ischemias, Cerebral,Ischemic Encephalopathies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000086 Acetazolamide One of the CARBONIC ANHYDRASE INHIBITORS that is sometimes effective against absence seizures. It is sometimes useful also as an adjunct in the treatment of tonic-clonic, myoclonic, and atonic seizures, particularly in women whose seizures occur or are exacerbated at specific times in the menstrual cycle. However, its usefulness is transient often because of rapid development of tolerance. Its antiepileptic effect may be due to its inhibitory effect on brain carbonic anhydrase, which leads to an increased transneuronal chloride gradient, increased chloride current, and increased inhibition. (From Smith and Reynard, Textbook of Pharmacology, 1991, p337) Acetadiazol,Acetazolam,Acetazolamide Sodium, (Sterile),Acetazolamide, Monosodium Salt,Ak-Zol,Apo-Acetazolamide,Diacarb,Diamox,Diuramide,Défiltran,Edemox,Glauconox,Glaupax,Huma-Zolamide,Ak Zol,AkZol,Apo Acetazolamide,ApoAcetazolamide,Huma Zolamide,HumaZolamide
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013349 Subclavian Steal Syndrome A clinically significant reduction in blood supply to the BRAIN STEM and CEREBELLUM (i.e., VERTEBROBASILAR INSUFFICIENCY) resulting from reversal of blood flow through the VERTEBRAL ARTERY from occlusion or stenosis of the proximal subclavian or brachiocephalic artery. Common symptoms include VERTIGO; SYNCOPE; and INTERMITTENT CLAUDICATION of the involved upper extremity. Subclavian steal may also occur in asymptomatic individuals. (From J Cardiovasc Surg 1994;35(1):11-4; Acta Neurol Scand 1994;90(3):174-8) Basilar Steal Syndrome,Brachial-Basilar Insufficiency Syndrome,Subclavian Artery Stenosis,Subclavian Steal,Subclavian Steal Phenomenon,Subclavian-Carotid Artery Steal Syndrome,Artery Stenoses, Subclavian,Artery Stenosis, Subclavian,Basilar Steal Syndromes,Brachial Basilar Insufficiency Syndrome,Brachial-Basilar Insufficiency Syndromes,Insufficiency Syndrome, Brachial-Basilar,Insufficiency Syndromes, Brachial-Basilar,Phenomenon, Subclavian Steal,Steal Phenomenon, Subclavian,Steal Syndrome, Basilar,Steal Syndrome, Subclavian,Steal Syndromes, Basilar,Steal Syndromes, Subclavian,Steal, Subclavian,Stenoses, Subclavian Artery,Stenosis, Subclavian Artery,Subclavian Artery Stenoses,Subclavian Carotid Artery Steal Syndrome,Subclavian Steal Syndromes,Syndrome, Brachial-Basilar Insufficiency,Syndromes, Brachial-Basilar Insufficiency

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