Regional cerebral hemodynamics during re-build-up phenomenon in childhood moyamoya disease. An analysis using 99mTc-HMPAO SPECT

Childs Nerv Syst. 1996 Mar;12(3):161-5. doi: 10.1007/BF00266821.


We investigated the role of ischemic hypoxia in the appearance of re-build-up phenomenon on electroencephalography in childhood moyamoya disease using 99mTc-hexamethyl propyleneamine oxime and single photon emission computed tomography (99mTc-HMPAO SPECT). In the case reported on, critical reduction of regional cerebral blood flow (rCBF) was observed during re-build-up phenomenon in the bilateral parieto-occipital area where acetazolamide testing revealed severe impairment of the perfusion reserve. On electroencephalography, the re-build-up phenomenon originated in these areas. In addition, re-build-up phenomenon developed into the entire hemisphere 30 s later, even where the severe ischemia was not observed. These results suggest that rCBF reduction induced by hyperventilation plays a critical role in the appearance of the re-build-up phenomenon, but other factors such as ischemic hypoxia after hyperventilation are also important in the development of this phenomenon.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / blood supply*
  • Brain / diagnostic imaging*
  • Brain / physiopathology
  • Cerebral Angiography
  • Child
  • Electroencephalography
  • Hemodynamics*
  • Humans
  • Hyperventilation
  • Moyamoya Disease / diagnosis*
  • Moyamoya Disease / physiopathology
  • Regional Blood Flow
  • Tomography, Emission-Computed, Single-Photon*