Single photon emission tomographic changes of rCBF in pediatric hydrocephalus

Purpose: Cerebrovascular changes resulting from hydrocephalus in children still remain to be investigated in detail. The aim of this study was to evaluate the effect of shunting on cerebral perfusion and regional cerebral blood flow (rCBF) in children with obstructive hydrocephalus. Methods: Technetium-99m hexamethyl propyleanine oxime (99mTC-HMPAO) single photon emission computed tomography (SPECT) was used to measure semiquantitatively the cerebral perfusion and rCBF pre- and post-operatively in 6 consecutive cases of hydrocephalus in children. Results: The mean percentage of rCBF in all lobes was calculated by subtracting the preoperative mean rCBF from the corresponding postoperative values. Semiquantitative data were obtained from pre- and postoperative transaxial SPECT images in the frontal, temporal, parietal and occipital areas. The ratios were calculated by dividing the mean count/pixel of the cerebellum. Shunting procedures determined significant increases in the mean cortical blood flow in all areas in the patients examined. Conclusions: These results reinforce the clinical significance of rCBF changes after shunting procedures in children with hydrocephalus. Although this study is based on a limited number of patients, it demonstrates the occurrence of reversible cerebrovascular changes resulting from hydrocephalus in children.