Stroke vs. status epilepticus. A case report utilizing CT perfusion

Royter, Vladimir; Paletz, Laurie; Waters, Michael F.

doi:10.1016/j.jns.2007.08.038

Cited by 24 publications

(25 citation statements)

References 7 publications

(5 reference statements)

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“…These results indicate that PCT-derived cortical perfusion maps discriminate NCSE and a postictal state. Thus, we have confirmed our previous results 22 and the findings of a recent case study 23 that investigated cortical hyperperfusion as a discriminating feature of NCSE. Some reports have found a persistence of cortical hyperperfusion after EEG cessation of epileptic seizures, 24,25 but such effects tend to switch rapidly (within 90 seconds of seizure end) into neocortical hypoperfusion 26 and have been excluded in our series because the time from cessation of convulsions to PCT ranged from 30 to 90 minutes.…”

Section: Quantitative Analysissupporting

confidence: 91%

Cortical Regional Hyperperfusion in Nonconvulsive Status Epilepticus Measured by Dynamic Brain Perfusion CT

Hauf¹,

Slotboom²,

Nirkko³

et al. 2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Nonconvulsive status epilepticus (NCSE) is associated with a mortality rate of up to 18%, therefore requiring prompt diagnosis and treatment. Our aim was to evaluate the diagnostic value of perfusion CT (PCT) in the differential diagnosis of NCSE versus postictal states in patients presenting with persistent altered mental states after a preceding epileptic seizure. We hypothesized that regional cortical hyperperfusion can be measured by PCT in patients with NCSE, whereas it is not present in postictal states.

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Section: Quantitative Analysissupporting

confidence: 91%

Cortical Regional Hyperperfusion in Nonconvulsive Status Epilepticus Measured by Dynamic Brain Perfusion CT

Hauf¹,

Slotboom²,

Nirkko³

et al. 2009

AJNR Am J Neuroradiol

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“…Less is known about its capacity to differentiate between cerebral ischaemia and nonvascular causes of neurological deficits with a sudden onset. Case series now report perfusion abnormalities in stroke mimics, such as hyperperfusion in the context of seizures [9, 10]. Our two cases demonstrate that perfusion CT is also able to differentiate a tumour or CHS that presents with neurological deficits with a sudden onset from cerebral ischaemia in the acute stage.…”

mentioning

confidence: 80%

Perfusion CT in suspected ischaemic stroke: red flags that should have been blue

et al. 2010

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“…With visual interpretation of color maps, this pattern can be mistaken for contralateral areas of the ischemia. 69,70 Currently, characteristics of CTP imaging in the setting of seizure have not been studied in depth. 69 The establishment of absolute quantitative CTP thresholds may be especially useful in such cases.…”

Section: Seizurementioning

confidence: 99%

“…69,70 Currently, characteristics of CTP imaging in the setting of seizure have not been studied in depth. 69 The establishment of absolute quantitative CTP thresholds may be especially useful in such cases. Recent work by Hauf et al 71 suggests that CTP can be used as an adjunct to electroencephalography to document ongoing seizure activity in patients with nonconvulsive status epilepticus, which may help in management of this difficult scenario.…”

Section: Seizurementioning

confidence: 99%

Evaluation of CT Perfusion in the Setting of Cerebral Ischemia: Patterns and Pitfalls

Lui¹,

Tang²,

Allmendinger³

et al. 2010

AJNR Am J Neuroradiol

116

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SUMMARY: CTP has a growing role in evaluating stroke. It can be performed immediately following NCCT and has advantages of accessibility and speed. Differentiation of salvageable ischemic penumbra from unsalvageable core infarct may help identify patients most likely to benefit from thrombectomy or thrombolysis. Still, CTP interpretation can be complex. We review normal and ischemic perfusion patterns followed by an illustrative series of technical/diagnostic challenges of CTP interpretation in the setting of acute stroke syndromes.ABBREVIATIONS: ACA ϭ anterior cerebral artery; AIF ϭ arterial input function; ASPECTS ϭ Alberta Stroke Program Early CT Score; CBF ϭ cerebral blood flow; CBV ϭ cerebral blood volume; CTA ϭ CT angiography; CTP ϭ CT perfusion; DWI ϭ diffusion-weighted imaging; ICA ϭ internal carotid artery; MCA ϭ middle cerebral artery; MTT ϭ mean transit time; NCCT ϭ noncontrast CT; PET ϭ positron-emission tomography; SPECT ϭ single-photon emission CT; TTP ϭ time to peak; VOF ϭ venous output function

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Stroke vs. status epilepticus. A case report utilizing CT perfusion

Cited by 24 publications

References 7 publications

Cortical Regional Hyperperfusion in Nonconvulsive Status Epilepticus Measured by Dynamic Brain Perfusion CT

Cortical Regional Hyperperfusion in Nonconvulsive Status Epilepticus Measured by Dynamic Brain Perfusion CT

Perfusion CT in suspected ischaemic stroke: red flags that should have been blue

Evaluation of CT Perfusion in the Setting of Cerebral Ischemia: Patterns and Pitfalls

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