The effects of olprinone (0.2 microg/kg per minute, i.v.) on cerebral blood flow were examined using technetium-99m-ethyl cysteinate dimer (99mTc-ECD) brain single-photon emission computed tomography in 14 stroke patients (69.0 +/- 5.6 years) and 12 normal subjects (68.1 +/- 6.2 years). The regional cerebral blood flow of the cerebral cortex was measured at six sites for each stroke patient (stroke group: n = 68, excluding 16 infarct areas confirmed on computed tomography image) and for each normal subject (normal group: n = 72). 99mTc-ECD brain single-photon emission computed tomography was repeated as the baseline 7 days after olprinone treatment study. The percent increment of the rCBF was 14.4 +/- 9.8% in the normal group and 10.7 +/- 11.7% in the stroke group (p = 0.002). The baseline value of the regional cerebral blood flow had a significant negative correlation with the increase of the regional cerebral blood flow in the normal group (r = -0.73, p < 0.0001) and in the stroke group (r = -0.43, p < 0.001). Although olprinone could dilate the cerebral vessels of stroke patients as well as those of normal subjects, smooth muscle dysfunction of the cerebral vessels due to advanced arteriosclerosis may reduce this effect.