Using positron emission tomography (PET), the regional cerebral metabolic rate of glucose consumption (rCMRGlc) was measured in 14 patients with Wilson's disease (WD) and 23 normal subjects. In WD patients, cerebellar, striatal and--to a lesser extent--cortical and thalamic rCMRGlc were significantly decreased compared with controls. Striatal rCMRGlc was significantly reduced in those 4 patients who had recently started decoppering therapy as compared with striatal rCMRGlc measured in those 10 patients with longer duration of medication. Caudate rCMRGlc correlated significantly with various signs of extrapyramidal dysfunction. Cerebellar, thalamic and cortical rCMRGlc correlated significantly with the severity of pyramidal signs. These data indicate that the PET measurement of rCMRGlc may be a useful tool to evaluate cerebral involvement in WD and to monitor the response to treatment.

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✓ Acute intracranial hemodynamic alterations consequent to arterial air embolism were studied in the dog using the radioxenon clearance technique. In eight dogs, the mean pre-embolic (control) hemispheric flow was 28.3 ml/100 gm/min. Following the injection of varying amounts of air into the right vertebral artery, there was an augmentation in the measured cerebral blood flow in all animals. Statistical analysis revealed the flow response to be independent of the amounts of air used in these experiments. The mean post-embolic cerebral blood flow was 39.3 ml/100 gm/min, representing a statistically significant increase of 11.0 ml/100 gm/min. Although the post-embolic supernormal flow may be due to the interaction of multiple pathophysiologic factors, air-induced traumatic vasodilatation is advocated as the most important pathogenetic mechanism. Prolonged vasodilatation with loss of autoregulation results in physiological shunting of blood through the affected capillary beds. Alterations in the intracerebral vasculature due to arterial air embolism are compared with studies by other investigators who have observed the effects in extracerebral vessels.

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