Aneurysmal 99mTc-HMPAO Uptake in Brain Death

Author:

Do Danka,Suhaj Petr1,Benes Jiri2,Matej Radoslav1,Lang Otto3

Affiliation:

1. Department of Pathology and Molecular Medicine, 3rd Faculty of Medicine, Thomayer University Hospital

2. Department of Radiology, General University Hospital Prague, Prague, Czech Republic.

3. Department of Radiology and Nuclear Medicine, 3rd Faculty of Medicine, University Hospital Kralovske Vinohrady

Abstract

Abstract A 41-year-old man was admitted to hospital due to sudden loss of consciousness. A regional brain perfusion SPECT/low-dose CT showed abnormal 99mTc-HMPAO uptake in the right hemisphere frontotemporally without any other supratentorial or infratentorial radiotracer uptake. A neuropathological examination disclosed a middle cerebral artery aneurysm. Presumably, vessel wall fibrosis prevented collapse. Multiple transmural dissections of the fibrotic aneurysmal wall were the source of the subarachnoid hemorrhage. This interesting image shows that radiotracer accumulation in cerebral artery aneurysms can be a diagnostic pitfall in brain death scintigraphy assessment.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference8 articles.

1. Scintigraphic confirmation of brain death;Semin Nucl Med,2021

2. Mechanisms of cerebral vasospasm and cerebral ischaemia in subarachnoid haemorrhage;Clin Physiol Funct Imaging,2023

3. SNM practice guideline for brain death scintigraphy 2.0;J Nucl Med Technol,2012

4. The autopsy of the brain and spinal cord in the diagnosis of neurodegenerative diseases—a practical approach to optimize the examination [in Czech];Cesk Patol,2015

5. Aneurysm formation, growth, and rupture: the biology and physics of cerebral aneurysms;World Neurosurg,2019

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