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Normal High-Resolution Cerebral 99mTc-HMPAO SPECT Scans in Symptomatic Neonates Exposed to Cocaine

Medical College of Wisconsin, Children's Hospital of Wisconsin, Department of Neurology Division of Pediatric Neurology, Oregon Health Sciences University, Portland, OR

Ronald S. Tikofsky, PhD

Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital Milwaukee, WI

Robert Wells, MD

Children's Hospital of Wisconsin

Robert S. Hellman, MD

Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital Milwaukee, WI

Penny Nemeth, RN, CPNP

Medical College of Wisconsin

David J. Walsh, MD

Medical College of Wisconsin, Children's Hospital of Wisconsin

Ruth Heimler, MD

Medical College of Wisconsin

John R. Sty, MD

Children's Hospital of Wisconsin

Vascular constriction is said to account for a variety of clinical effects of cocaine. High-resolution ^99mTc-hexamethyl-propylene amine oxime single photon emission computed tomographic (SPECT) scans, which measure cerebral blood flow, were used to determine whether neonatal brain perfusion deficits are present in newborns with confirmed cocaine exposure. Normal, age-appropriate SPECT scans were found in 21 babies. Conventional neuroimaging was also performed when possible. All but one of the 14 magnetic resonance imaging (MRI) scans and one computed tomographic scan were normal. One MRI showed a mild delay in myelination. All but four neonates had behavioral or electroencephalographic abnormalities, and microcephaly was found in five of 21. The normal neonatal SPECT scans contrast with findings in adult cocaine users, which typically report abnormal findings of cerebral hypoperfusion. This study identifies a unique lack of corresponding cerebral vascular pathology in symptomatic neonates. It raises the possibility that many of these children can escape significant ischemic injury. (J Child Neurol 1994;9:278-280).

Journal of Child Neurology, Vol. 9, No. 3, 278-283 (1994)
DOI: 10.1177/088307389400900311


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