Cerebral Hypervascularity and Early Venous Opacification in Status Epilepticus

McDonald, Eugene J.; Goodman, Philip C.; Nielsen, Surl L.; Winestock, David P.

doi:10.1148/117.1.87

Cited by 2 publications

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“…2,3,16,28,32,33) The convulsive seizure that occurred 2 days after the onset of symptoms, and the post-traumatic clinical course together with the neuroimaging findings required us to exclude the diagnosis of status epilepticus of the nonconvulsive type. Cerebral angiography has detected vascular hyperemia, capillary brush, and early draining veins in patients with status epilepticus, 17,21,34) which are compatible with the increased blood flow in SPECT that is generally seen in status epilepticus. 11,16,32) Neuroimaging signs of transient abnormalities in patients with status epilepticus characteristically involve a focal area either in the white matter or in the combined white and gray matter, appearing as low density areas by CT, and as decreased signal intensity on T 1 -weighted images and/or increased signal intensity on T 2 -weighted ones by MR imaging, without a mass effect.…”

Section: Discussionmentioning

confidence: 81%

Delayed, Transient Neurological Deterioration After Mild Head Injury. Case Report.

Urasaki

Yasukouchi

Yokota

et al. 2001

Neurol. Med. Chir.(Tokyo)

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A 16-year-old boy presented with delayed, transient neurological deterioration 18 days after mild head injury. Left hemiparesis and left homonymous hemianopsia appeared after right frontal contusional and mild subdural hematomas subsided. Neuroimaging examinations including cerebral angiography, magnetic resonance imaging, and single photon emission computed tomography showed vasodilation and hyperemia in the right cerebral hemisphere. The present case is not typical of acute``juvenile head trauma syndrome,'' but may represent a possible pathophysiology of the delayed type of transient neurological deterioration after mild head injury.

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Section: Discussionmentioning

confidence: 81%

Delayed, Transient Neurological Deterioration After Mild Head Injury. Case Report.

Urasaki

Yasukouchi

Yokota

et al. 2001

Neurol. Med. Chir.(Tokyo)

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“…McDonald et al. 5 reported a case of cerebral hypervascularity and early venous opacification in a patient with status epilepticus. The patient died.…”

Section: Discussionmentioning

confidence: 99%

Early cerebral venous drainage associated with focal seizures: a correlation of digital subtraction angiography and electroencephalography. Illustrative case

Holman,

Bibawy,

Wadi

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Early venous drainage is a critical diagnostic feature of arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs). However, other conditions associated with early venous drainage can mimic AVMs and AVFs and mislead the treating physician team. OBSERVATIONS The authors present a unique case of a 56-year-old man with new left hemianopsia. Workup with magnetic resonance imaging and magnetic resonance angiography had revealed cortical enhancement and early venous drainage, possibly caused by an AVF or AVM. Catheter angiography confirmed the presence of early venous drainage of specifically the right occipital lobe. The early venous drainage occurred as the result of local hyperperfusion limited to the right occipital lobe. Subsequent electroencephalography confirmed focal seizure activity in the right occipital lobe. After seizure control with multiple antiepileptic medications, the patient regained his vision. Repeat digital subtraction angiography revealed restoration of normal cerebral blood flow. LESSONS Early venous drainage observed during catheter angiography can be associated with seizure activity. Differentiation from other conditions, such as AVM, AVF, or ischemic stroke, is critical to facilitate prompt and appropriate treatment.

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Cerebral Hypervascularity and Early Venous Opacification in Status Epilepticus

Abstract: Cerebral hyperperfusion and early draining veins directly resulting from status epilepticus can be demonstrated angiographically. Postmortem examination of the brain excluded other possible causes of hyperemia and early venous drainage.

Cited by 2 publications

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Delayed, Transient Neurological Deterioration After Mild Head Injury. Case Report.

Delayed, Transient Neurological Deterioration After Mild Head Injury. Case Report.

Early cerebral venous drainage associated with focal seizures: a correlation of digital subtraction angiography and electroencephalography. Illustrative case

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