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cerebral hyperperfusion

Hidehito Kimura, Masaaki Taniguchi, Tatsuya Mori, Kohkichi Hosoda, Eiji Kohmura
We present a rare case of a patient suffering temporary aphasia after an extracranial-to-intracranial (EC-IC) bypass surgery, which was shown as a transient hypointense lesion on diffusion-weighted imaging (DWI) with increased apparent diffusion coefficient (ADC) value, evidence of postoperative hyperperfusion. Postoperative hyperperfusion syndrome after EC-IC bypass causing temporary neurological deterioration has been reported rarely as isosignal intensity on DWI with hyperintense lesion on T2-weighted image and fluid-attenuated inversion recovery (FLAIR) image as an expression of vasogenic edema...
October 14, 2016: World Neurosurgery
Chia-Ju Liu, Hsin-Hsi Tsai, Kuan-Yin Ko, Ching-Chu Lu, Ruoh-Fang Yen
A 68-year-old man with diabetes mellitus type 2 presented himself with visual distortion and apraxia. Nonketotic hyperglycemic seizure with both motor and sensory components was suspected. Tc-ECD perfusion SPECT demonstrated hyperperfusion at right parieto-occipital lobe during ictal phase. Normalization of hyperperfused area was noted on follow-up perfusion SPECT after intense glucose control. In nonketotic hyperglycemic state, the depletion of GABA in cerebral neurons lowers the seizure threshold. We demonstrated that ictal phase perfusion SPECT contributed to not only diagnosis but also served as a follow-up tool...
October 5, 2016: Clinical Nuclear Medicine
Sebastian Walther, Lea Schäppi, Andrea Federspiel, Stephan Bohlhalter, Roland Wiest, Werner Strik, Katharina Stegmayer
Catatonia is a psychomotor syndrome that not only frequently occurs in the context of schizophrenia but also in other conditions. The neural correlates of catatonia remain unclear due to small-sized studies. We therefore compared resting-state cerebral blood flow (rCBF) and gray matter (GM) density between schizophrenia patients with current catatonia and without catatonia and healthy controls. We included 42 schizophrenia patients and 41 controls. Catatonia was currently present in 15 patients (scoring >2 items on the Bush Francis Catatonia Rating Scale screening)...
October 11, 2016: Schizophrenia Bulletin
Grace J Wang, Adam W Beck, Randall R DeMartino, Philip P Goodney, Caron B Rockman, Ronald M Fairman
BACKGROUND: Cerebral hyperperfusion syndrome (CHS), characterized by severe ipsilateral headache, seizures, and intracranial hemorrhage, is a rare, poorly understood complication that can be fatal following carotid endarterectomy (CEA). The purpose of the study was to determine the factors associated with CHS as captured in the Vascular Quality Initiative. METHODS: Analysis was conducted on 51,001 procedures captured from the CEA module of the Vascular Quality Initiative from 2003 to 2015...
October 1, 2016: Journal of Vascular Surgery
Na-Rae Yang, Pyoung Jeon, Byungjun Kim, Keon Ha Kim, Kyungil Jo
BACKGROUND: While carotid angioplasty and stenting (CAS) has become an established procedure, outcomes of early CAS for symptomatic extracranial carotid stenosis (SECS) remain poorly understood. The present study aimed at determining the effectiveness of early CAS in SECS. METHODS: Herein, 224 SECS patients underwent elective CAS between January 2008 and June 2015. The study population was stratified based on the time from symptom onset to the procedure (early CAS group: within 14 days; delayed CAS group: later than 14 days)...
September 15, 2016: World Neurosurgery
Rosa Maria Cerbo, Simona Orcesi, Luigia Scudeller, Martina Borellini, Carolina Croci, Claudia Ravelli, Giulia Masa, Piermichele Paolillo, Paolo Manzoni, Umberto Balottin, Mauro Stronati
Objective We aimed at assessing the association between superior vena cava flow (SVCf), regional (cerebral) tissue oxygen saturation (rSO2), and cerebral fractional oxygen extraction (CFOE) during the first 48 hours of life and 2-years neurodevelopmental outcome of very low-birth-weight infants (VLBW). Methods We prospectively studied 60 VLBW infants admitted to our neonatal intensive care unit; rSO2 was continuously monitored with near-infrared spectroscopy during the first 48 hours of life, SVCf was measured at 4 to 6, 12, 24, and 48 hours, and CFOE was calculated...
September 2016: American Journal of Perinatology
Muhammad U Farooq, Christopher Goshgarian, Jiangyong Min, Philip B Gorelick
Cerebral hyperperfusion is a relatively rare syndrome with significant and potentially preventable clinical consequences. The pathophysiology of cerebral hyperperfusion syndrome (CHS) may involve dysregulation of the cerebral vascular system and hypertension, in the setting of increase in cerebral blood flow. The early recognition of CHS is important to prevent complications such as intracerebral hemorrhage. This review will focus on CHS following carotid endarterectomy and carotid artery stenting. We will discuss the typical clinical features of CHS, risk factors, pathophysiology, diagnostic modalities for detection, identification of patients at risk, and prevention and treatment...
2016: Experimental & Translational Stroke Medicine
Ken Kazumata, Khin Khin Tha, Haruto Uchino, Tohru Shiga, Hideo Shichinohe, Masaki Ito, Naoki Nakayama, Takeo Abumiya
OBJECTIVE After revascularization surgery, hyperperfusion and ischemia are associated with morbidity and mortality in adult moyamoya disease (MMD). However, structural changes within the brain following revascularization surgery, especially in the early postsurgical period, have not been thoroughly studied. Such knowledge may enable improved monitoring and clinical management of hyperperfusion and ischemia in MMD. Thus, the objective of this study was to investigate the topographic and temporal profiles of cerebral perfusion and related white matter microstructural changes following revascularization surgery in adult MMD...
September 2, 2016: Journal of Neurosurgery
Young-Do Kim, Hyeonseok S Jeong, In-Uk Song, Yong-An Chung, Eun Namgung, Yong-Duk Kim
OBJECTIVE: Although Parkinson's disease (PD) is frequently accompanied by depression, brain perfusion deficits in PD with depression remain unclear. This study aimed to assess alterations in regional cerebral blood flow (rCBF) in depressed PD patients using (99m)Tc hexamethyl-propylene-amine-oxime single-photon emission computed tomography (SPECT). METHODS: Among 78 patients with PD, 35 patients were classified into the depressed PD group, while the rest (43 patients) was assigned to the nondepressed PD group based on the scores of the Geriatric Depressive Scale (GDS)...
August 26, 2016: Annals of Nuclear Medicine
Hiroshi Enaida, Shinji Nagata, Atsunobu Takeda, Shintaro Nakao, Yasuhiro Ikeda, Tatsuro Ishibashi
PURPOSE: To investigate the changes in chorioretinal blood flow velocity and cerebral blood after carotid endarterectomy (CEA). METHODS: Nine patients with moderate to severe internal carotid artery stenosis underwent CEA. Chorioretinal blood flow velocity was measured by laser speckle flowgraphy (LSFG), while cerebral blood flow (CBF) was measured by single-photon emission computed tomography (SPECT), on the affected side both before and after CEA. LSFG was evaluated in five areas to determine mean blur rate, while CBF was calculated from regional CBF and cerebrovascular reactivity (CVR), at the middle cerebral artery (MCA) region of each patient...
August 26, 2016: Japanese Journal of Ophthalmology
Motohiro Nomura, Akira Tamase, Tomoya Kamide, Kentaro Mori, Syunsuke Seki, Yu Iida, Kei-Ichiro Suzuki, Takae Aoki, Ken-Ichi Hirano, Mitsuyuki Takahashi, Yuichi Kawabata, Tatsu Nakano, Hiroki Taguchi
We report a patient with a traumatic middle cerebral artery dissection, which showed hyperperfusion in the territory supplied by the left middle cerebral artery. A 45-year-old man experienced speech disturbance and motor weakness in his right hemibody on the day following mild head trauma. His symptoms worsened on the fourth day. Magnetic resonance imaging showed narrowing in the left M1 portion of the middle cerebral artery. Angiography showed narrowing and dilatation in the left middle cerebral artery trunk...
October 2016: Neuroradiology Journal
Eric Nyberg, Justin Honce, Bette K Kleinschmidt-DeMasters, Brian Shukri, Sarah Kreidler, Lidia Nagae
BACKGROUND: Standard of care for high-grade gliomas (HGGs) includes surgical debulking and adjuvant chemotherapy and radiation. Patients under treatment require frequent clinical and imaging monitoring for therapy modulation. Differentiating tumor progression from treatment-related changes can be challenging on conventional MRI, resulting in delayed recognition of tumor progression. Arterial spin labeling (ASL) may be more sensitive for tumor progression. MATERIALS AND METHODS: ASL and associated conventional MR images obtained in patients previously treated for HGGs and before biopsy or re-resection were reviewed by three neuroradiologists who were blinded to the histopathologic results...
October 2016: Neuroradiology Journal
Kentaro Fujimoto, Yoshiyasu Matsumoto, Kohki Oikawa, Jun-Ichi Nomura, Yasuyoshi Shimada, Shunrou Fujiwara, Kazunori Terasaki, Masakazu Kobayashi, Kenji Yoshida, Kuniaki Ogasawara
The purpose of the present study was to determine whether cerebral hyperperfusion after revascularization inhibits development of cerebral ischemic lesions due to artery-to-artery emboli during exposure of the carotid arteries in carotid endarterectomy (CEA). In patients undergoing CEA for internal carotid artery stenosis (≥70%), cerebral blood flow (CBF) was measured using single-photon emission computed tomography (SPECT) before and immediately after CEA. Microembolic signals (MES) were identified using transcranial Doppler during carotid exposure...
2016: International Journal of Molecular Sciences
Jonathan Khalifa, Fatima Tensaouti, Jean-Albert Lotterie, Isabelle Catalaa, Leonor Chaltiel, Alexandra Benouaich-Amiel, Carlos Gomez-Roca, Georges Noël, Gilles Truc, Patrice Péran, Isabelle Berry, Marie-Pierre Sunyach, Marie Charissoux, Corinne Johnson, Elizabeth Cohen-Jonathan Moyal, Anne Laprie
To assess the value of T2* dynamic-susceptibility contrast MRI (DSC-MRI) and diffusion-weighted imaging (DWI) to predict the glioblastoma relapse sites after chemoradiation. From a cohort of 44 patients, primarily treated with radiotherapy (60 Gy) and concomitant temozolomide for glioblastoma, who were included in the reference arm of a prospective clinical trial (NCT01507506), 15 patients relapsed and their imaging data were analyzed. All patients underwent anatomical MRI, DSC-MRI and DWI before radiotherapy and every 2 months thereafter until relapse...
August 8, 2016: Journal of Neuro-oncology
K Schmidt, T Pottgießer, S Meckel, D Duerschmied, C Bode, J Reinöhl
This article presents the case of a combined intervention for transcatheter aortic valve implantation (TAVI) and stenting of the internal carotid artery. Due to severe aortic stenosis and a subacute infarction in the middle cerebral artery territory, with neurological instability while hypotensive and cardiac failure while hypertensive, it was decided to carry out the intervention as a single combined procedure. An open surgical intervention was decided against because of the high peri-interventional mortality risk...
August 8, 2016: Der Internist
Jinlu Yu, Lei Shi, Yunbao Guo, Baofeng Xu, Kan Xu
Moyamoya disease (MMD) involves progressive occlusion of the intracranial internal carotid artery resulting in formation of moyamoya-like vessels at the base of the brain. It can be characterized by hemorrhage or ischemia. Direct vascular bypass is the main and most effective treatment of MMD. However, patients with MMD differ from those with normal cerebral vessels. MMD patients have unstable intracranial artery hemodynamics and a poor blood flow reserve; therefore, during the direct bypass of superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis, perioperative risk factors and anesthesia can affect the hemodynamics of these patients...
2016: International Journal of Medical Sciences
Rajeev Kumar Verma, Eugenio Abela, Kaspar Schindler, Heinz Krestel, Elisabeth Springer, Adrian Huber, Christian Weisstanner, Martinus Hauf, Jan Gralla, Roland Wiest
OBJECTIVE: The aim of this study was to investigate variant patterns of cortical venous oxygenation during status epilepticus (SE) using susceptibility-weighted imaging (SWI). METHODS: We analyzed magnetic resonance imaging (MRI) scans of 26 patients with clinically witnessed prolonged seizures and/or EEG-confirmed SE. All MRI exams encompassed SWI, dynamic susceptibility contrast perfusion MRI (MRI-DSC) and diffusion-weighted imaging (DWI). We aimed to identify distinct patterns of SWI signal alterations that revealed regional or global increases of cerebral blood flow (CBF) and DWI restrictions...
2016: PloS One
Stefan C Kane, Shaun P Brennecke, Fabricio da Silva Costa
The neurological complications of pre-eclampsia, including eclampsia (seizures) and intracerebral haemorrhage, are responsible for much of the maternal morbidity and mortality associated with this condition. Animal models and neuroimaging in humans suggest that pre-eclampsia is associated with a loss of cerebral autoregulation, which consequent hyperperfusion and vasogenic oedema. Treatments given to pre-eclamptic women are aimed at preventing these cerebral sequelae, and include antihypertensive agents (to prevent intracranial haemorrhage) and magnesium sulphate (for seizure prophylaxis)...
August 3, 2016: Ultrasound in Obstetrics & Gynecology
Makoto Isozaki, Yoshikazu Arai, Yoshifumi Higashino, Hidehiko Okazawa, Ken-Ichiro Kikuta
A 64-year-old, right-handed man underwent endovascular treatment for internal carotid artery stenosis after experiencing a left-hemispheric transient ischemic attack. (15)O-gas and H 2 (15) O positron emission tomography revealed slightly reduced cerebral blood flow (CBF), elevated cerebral blood volume, and severely reduced cerebral vasoreactivity in the ipsilateral hemisphere as determined by an acetazolamide challenge test. The patient underwent left carotid artery stenting (CAS) via a prefemoral approach under local anesthesia without any complications...
August 2, 2016: Annals of Nuclear Medicine
Akihiro Inoue, Kanehisa Kohno, Shinya Fukumoto, Saya Ozaki, Satoko Ninomiya, Hitomi Tomita, Kenji Kamogawa, Kensho Okamoto, Haruhisa Ichikawa, Shinji Onoue, Hajime Miyazaki, Bungo Okuda, Shinji Iwata
INTRODUCTION: We report a patient treated successfully via endovascular surgery within 24h after intravenous thrombolysis using recombinant tissue plasminogen activator for acute cervical internal carotid artery occlusion. PRESENTATION OF CASE: A 68-year-old man was admitted to our hospital. Neurological examination revealed severe left-sided motor weakness. Magnetic resonance imaging showed no cerebral infarction, but magnetic resonance angiography revealed complete occlusion of the right internal carotid artery...
2016: International Journal of Surgery Case Reports
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