Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
권호 표지
DOI QR코드

DOI QR Code

Perfusion MR Imaging of Seizure-related Cerebral Cortical Lesion: A Case Report

발작에 의한 대뇌피질 병변의 관류 MR영상: 증례 보고

  • Seo, Hyemin (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Choi, Dae Seob (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Shin, Hwa Seon (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Son, Seungnam (Department of Neurology, Gyeongsang National University School of Medicine)
  • 서혜민 (경상대학교 의학전문대학원 영상의학교실) ;
  • 최대섭 (경상대학교 의학전문대학원 영상의학교실) ;
  • 신화선 (경상대학교 의학전문대학원 영상의학교실) ;
  • 손승남 (경상대학교 의학전문대학원 신경과학교실)
  • Received : 2013.11.16
  • Accepted : 2013.11.26
  • Published : 2013.12.27
Download PDF
⟨ Previous Next ⟩

Abstract

When cerebral cortical hyperintensities on diffusion-weighted image are seen in patients with suspected acute stroke accompanying seizure, it is necessary to differentiate whether they are caused by infarction or seizure-related change. We report a case of seizure-related cortical hypertensities in a patient with suspected acute infarction. With perfusion MR imaging, we could differentiate from acute infarction.

발작을 동반한 급성 뇌경색이 의심되는 환자에서 대뇌피질에 고신호 강도의 병변이 확산강조영상에서 보일 때 뇌경색에 의한 병변인지 발작에 동반된 이차적 병변인지 구분하는 것은 혈전용해제의 치료방침과 관련하여 대단히 중요하다. 발작을 동반한 뇌경색이 의심되는 환자에서 관류 MR영상을 이용하여 뇌경색과 감별이 가능하였던 발작에 동반된 대뇌피질의 고신호 강도를 보였던 1예를 보고하고자 한다.

Keywords

References

  1. Cianfoni A, Caulo M, Cerase A, et al. Seizure-induced brain lesions: a wide spectrum of variably reversible MRI abnormalities. Eur J Radiol 2013;82:1964-1972 https://doi.org/10.1016/j.ejrad.2013.05.020
  2. Kim JA, Chung JI, Yoon PH, et al. Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: periictal diffusion-weighted imaging. AJNR Am J Neuroradiol 2001;22:1149-1160
  3. Kirog ̆lu Y, Calli C, Yunten N, et al. Diffusion-weighted MR imaging of viral encephalitis. Neuroradiology 2006;48:875-880 https://doi.org/10.1007/s00234-006-0143-7
  4. Reith J, J􀝚rgensen HS, Nakayama H, Raaschou HO, Olsen TS. Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study. Stroke 1997;28:1585-1589 https://doi.org/10.1161/01.STR.28.8.1585
  5. The Multicenter Acute Stroke Trial-Europe Study Group. Thrombolytic therapy with streptokinase in acute ischemic stroke. N Engl J Med 1996;335:145-150 https://doi.org/10.1056/NEJM199607183350301
  6. Gutierrez LG, Rovira A, Portela LA, Leite Cda C, Lucato LT. CT and MR in non-neonatal hypoxic-ischemic encephalopathy: radiological findings with pathophysiological correlations. Neuroradiology 2010;52:949-976 https://doi.org/10.1007/s00234-010-0728-z
  7. Masterson K, Vargas MI, Delavelle J. Postictal deficit mimicking stroke: role of perfusion CT. J Neuroradiol 2009;36:48-51 https://doi.org/10.1016/j.neurad.2008.08.006
  8. Szabo K, Poepel A, Pohlmann-Eden B, et al. Diffusion-weighted and perfusion MRI demonstrates parenchymal changes in complex partial status epilepticus. Brain 2005;128:1369-1376 https://doi.org/10.1093/brain/awh454
  9. Hochberg AR, Young GS. Cerebral perfusion imaging. Semin Neurol 2012;32:454-465