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Brain, Vol. 113, No. 5, 1395-1404, 1990
© 1990 Guarantors of Brain

research-article

CEREBRAL BLOOD FLOW IN PROGRESSIVE APHASIA WITHOUT DEMENTIA

CASE REPORT, USING 133XENON INHALATION, TECHNETIUM 99m HEXAMETHYLPROPYLENEAMINE OXIME AND SINGLE PHOTON EMISSION COMPUTERIZED TOMOGRAPHY

FLORENCE DELECLUSE1, ALLAN R. ANDERSEN2,, GUNHILD WALDEMAR2, ANNE-MARIE THOMSEN2, LASSE KJAER3, NIELS A. LASSEN4 and ALFREDO POSTIGLIONE5

1Department of Nuclear Medicine, Erasmus Hospital Brussels, Belgium 2Department of Neurology Rigshospitalet 3Department of Magnetic Resonance, Hvidovre Hospital Copenhagen, Denmark 4Department of Clinical Physiology, Bispebjerg Hospital Copenhagen, Denmark 5Institute of Internal Medicine and Metabolic Diseases Naples, Italy

Correspondence to: Correspondence to: Dr Allan R. Andersen, Department of Neurology, Rigshospitalet, Blegdamsvej 9, 2100, København Ø, Denmark.

We report a case of progressive aphasia without clinical signs of intellectual or behavioural impairment, satisfying Mesulam's clinical criteria of primary progressive aphasia, as 4 yrs of extensive psychometric testing and radiological imaging, comprising CT and MRI, failed to detect evidence of relevant involvement outside the left perisylvian regions. Cranial CT was normal but MRI showed multiple bilateral lesions in the deep white matter. Cerebral blood flow (CBF) studies by single photon emission computerized tomography, however, showed an initial frontotemporal focus of hypoperfusion that progressively extended to include most of the ipsilateral hemisphere and the contralateral frontal lobe. This suggests that CBF imaging may yet be the most sensitive technique in revealing subclinical injury in the degenerative brain diseases of focal onset.

Received April 12, 1989. Revised September 19, 1989. Accepted October 18, 1989.


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