Changes in the basal ganglia and thalamus following reperfusion after complete cerebral ischaemia

Fujioka, Masayuki; Okuchi, Kazuo; Miyamoto, Seiji; Sakaki, Toshisuke; Hiramatsu, Kazuhiro; Tominaga, Mitsuhiro; Kamada, Yoshitaka; Iwasaki, Shigeo

doi:10.1007/bf00600418

Cited by 20 publications

(9 citation statements)

References 18 publications

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“…First, none of the patients had hypotensive or hypoxemic episodes immediately before the onset. Second, the neuroimaging findings of significant basal ganglia edema and mass effect seen in eight of the patients are unusual for cerebral hypoxia [1,9,10,17,28,32]. Furthermore, many of our patients showed initial clinical improvement after onset, as opposed to the persistent grave outcome seen in most reported cases of cerebral hypoxia resulting from circulatory arrest.…”

Section: Discussionmentioning

confidence: 88%

“…The symmetrical basal ganglia lesions described here were unusual for simple thromboembolic disease. Brain hypoxia secondary to hypotension or global anoxia has similar neuroimaging changes [1,9,10,17,28,32]. However, brain hypoxia can hardly explain all features in the present patient series.…”

Section: Discussionmentioning

confidence: 90%

“…The clinical characteristics and shortterm outcomes of three among these six patients (patients 10,11,12) had been published previously [37]. Aside from theses 6 patients, we also reviewed the medical records of all patients who were hospitalized from March 1996 to August 2000 for uremia-associated conditions.…”

Section: Methodsmentioning

confidence: 99%

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The syndrome of acute bilateral basal ganglia lesions in diabetic uremic patients

Wang¹,

2003

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Acute extrapyramidal movement disorders have rarely been reported in uremic patients. We had previously presented three cases of acute movement disorders with bilateral basal ganglia lesions in uremia, and had proposed that it is not a rare condition. The objective of this study is to establish a more accurate clinical profile of this rarely described clinical syndrome, and to call attention to its common occurrence. We prospectively studied six patients we encountered from March 1996 to June 2001. We also reviewed the clinical records of a large population of uremic patients and identified six more cases. The clinical manifestations, laboratory findings, neuroimages, and clinical outcomes of these 12 patients were analyzed. When possible, each patient was followed up to the present time. Twelve patients had acute onset of movement disorders and bilateral basal ganglia lesions. All of the patients were diabetic. They had acute-onset Parkinsonism or dyskinesias, together with various symptoms such as consciousness disturbance, dysarthria, dysphagia, or ataxia. The main laboratory test results of abnormalities consisted of elevated blood urea nitrogen, creatinine, and metabolic acidosis. They had uniform neuroimaging findings of symmetrical bilateral basal ganglion changes. These changes regressed or disappeared during follow-up. The clinical prognoses were diverse. We believe that this group of patients represents a well-demarcated clinical syndrome, which is not uncommon but has previously been rarely addressed. The underlying mechanism of such lesions may be associated with metabolic, as well as vascular factors.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 90%

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The syndrome of acute bilateral basal ganglia lesions in diabetic uremic patients

Wang¹,

2003

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“…These lesions are most likely due to the escape of red blood cells through the damaged capillary endothelium in the ischemic regions 2,3,5,19,20 .…”

Section: Discussionmentioning

confidence: 99%

Cryptogenic Stroke in Hanging

Garaci

Bazzocchi²,

Velari³

et al. 2009

Neuroradiol J

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This paper reports the unique neuroimaging findings of a 37-year-old woman who attempted suicide by hanging. To our knowledge, this is the first reported case describing neuroimaging findings of unilateral lesions instead of the well-documented bilateral lesions after a hanging event. Computed tomography demonstrated a low density area in the right thalamus and no hemorrhage. 3.0 T Magnetic resonance revealed a hyperintense area on both T2-weighted and FLAIR images on the right thalamus. Diffusion weighted images demonstrated no area of diffusivity restriction. Another smaller lesion with the same signal characteristics was found in the left cerebellum. A second relevant point of this report is the observation that the most probable cause of the documented unilateral lesions was an ischemic-arterial event.

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“…There are no LOE P1-or LOE P2-studies that support the use of computed tomography (CT) imaging to predict outcome of comatose cardiac arrest survivors. Use of CT imaging is supported by 22 studies (LOE P3 992 ; LOE P4 969,984,[993][994][995][996][997][998][999][1000][1001] ; LOE P5 980,981,985,[1002][1003][1004][1005][1006] ). The timing of CT in those studies ranged from 1 hour to 20 days after sustained ROSC.…”

Section: Consensus On Sciencementioning

confidence: 99%