Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report
Heat stroke may cause multi-organ dysfunction and death. Some patients with neurological abnormalities in the acute phase have neurological sequelae, particularly cerebellar ataxia, in the recovery phase. However, there is no method to predict the neurological prognosis, and the usefulness of imagin...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023054932 |
| _version_ | 1797771452172206080 |
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| author | Keisuke Suzuki Kazuyuki Miyamoto Takahiro Kanai Mariko Kurihara Kazuki Kikuchi Kohei Harano Akihito Kato Masaharu Yagi Yoshimitsu Ohgiya Kenji Dohi |
| author_facet | Keisuke Suzuki Kazuyuki Miyamoto Takahiro Kanai Mariko Kurihara Kazuki Kikuchi Kohei Harano Akihito Kato Masaharu Yagi Yoshimitsu Ohgiya Kenji Dohi |
| author_sort | Keisuke Suzuki |
| collection | DOAJ |
| description | Heat stroke may cause multi-organ dysfunction and death. Some patients with neurological abnormalities in the acute phase have neurological sequelae, particularly cerebellar ataxia, in the recovery phase. However, there is no method to predict the neurological prognosis, and the usefulness of imaging has not yet been established. We report the case of an 86-year-old woman with dementia brought to our emergency department in a coma and hyperthermia. The patient was diagnosed with heat stroke and promptly treated in the ICU but remained unconscious. The patient gained consciousness on day 19, but difficulty with stillness associated with cerebellar ataxia in her right upper extremity became apparent. On day 1, head magnetic resonance imaging (MRI) showed no obvious abnormality. However, on day 6, high-signal areas, suggestive of edema, were seen in the bilateral cerebellar hemispheres. Single-photon emission computed tomography (SPECT) on day 9 revealed significant hypoperfusion in the right cerebellum. These changes improved at the time of hospital discharge. This was a case of persistent cerebellar ataxia due to heat stroke, in which imaging findings improved over time. In most cases, MRI findings do not match clinical symptoms. However, the low cerebral blood flow in the early SPECT images was consistent with the clinical symptoms. MRI may not be a prognostic indicator; however, SPECT images may be useful for predicting sequelae. |
| first_indexed | 2024-03-12T21:36:47Z |
| format | Article |
| id | doaj.art-bb5089f59a814c75841c956d136a6c1a |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-12T21:36:47Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-bb5089f59a814c75841c956d136a6c1a2023-07-27T05:59:09ZengElsevierHeliyon2405-84402023-07-0197e18285Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case reportKeisuke Suzuki0Kazuyuki Miyamoto1Takahiro Kanai2Mariko Kurihara3Kazuki Kikuchi4Kohei Harano5Akihito Kato6Masaharu Yagi7Yoshimitsu Ohgiya8Kenji Dohi9Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan; Department of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan; Corresponding author. Department of Emergency and Disaster Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, JapanDepartment of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, JapanDepartment of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, JapanDepartment of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, JapanDepartment of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, JapanDepartment of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan; Department of Emergency and Disaster Medicine, Showa University, Yokohama Northern Hospital, 35-1 Chigasaki Chuo Tsuzuki-ku, Yokohama 224-8503, JapanDepartment of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, JapanDepartment of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, JapanDepartment of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, JapanHeat stroke may cause multi-organ dysfunction and death. Some patients with neurological abnormalities in the acute phase have neurological sequelae, particularly cerebellar ataxia, in the recovery phase. However, there is no method to predict the neurological prognosis, and the usefulness of imaging has not yet been established. We report the case of an 86-year-old woman with dementia brought to our emergency department in a coma and hyperthermia. The patient was diagnosed with heat stroke and promptly treated in the ICU but remained unconscious. The patient gained consciousness on day 19, but difficulty with stillness associated with cerebellar ataxia in her right upper extremity became apparent. On day 1, head magnetic resonance imaging (MRI) showed no obvious abnormality. However, on day 6, high-signal areas, suggestive of edema, were seen in the bilateral cerebellar hemispheres. Single-photon emission computed tomography (SPECT) on day 9 revealed significant hypoperfusion in the right cerebellum. These changes improved at the time of hospital discharge. This was a case of persistent cerebellar ataxia due to heat stroke, in which imaging findings improved over time. In most cases, MRI findings do not match clinical symptoms. However, the low cerebral blood flow in the early SPECT images was consistent with the clinical symptoms. MRI may not be a prognostic indicator; however, SPECT images may be useful for predicting sequelae.http://www.sciencedirect.com/science/article/pii/S2405844023054932Heat strokeMRISPECTCerebellar ataxiaCase report |
| spellingShingle | Keisuke Suzuki Kazuyuki Miyamoto Takahiro Kanai Mariko Kurihara Kazuki Kikuchi Kohei Harano Akihito Kato Masaharu Yagi Yoshimitsu Ohgiya Kenji Dohi Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report Heliyon Heat stroke MRI SPECT Cerebellar ataxia Case report |
| title | Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report |
| title_full | Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report |
| title_fullStr | Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report |
| title_full_unstemmed | Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report |
| title_short | Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report |
| title_sort | single photon emission computed tomography spect predicted neurological prognosis in heat stroke a case report |
| topic | Heat stroke MRI SPECT Cerebellar ataxia Case report |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023054932 |
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