- 著者
- Hiroshi Oketani Takato Morioka Satoshi Inoha Kenji Miki Takafumi Shimogawa Nobutaka Mukae Ayumi Sakata Hiroshi Shigeto Koji Yoshimoto
- 出版者
- JAPAN EPILEPSY SOCIETY
- 雑誌
- Epilepsy & Seizure (ISSN:18825567)
- 巻号頁・発行日
- vol.15, no.1, pp.59-66, 2023 (Released:2023-09-26)
- 参考文献数
- 17
- 被引用文献数
- 1
Introduction: Arterial spin labeling (ASL) magnetic resonance (MR) perfusion imaging is useful for diagnosing non-convulsive status epilepticus (NCSE) as it visualizes ictal hyperperfusion in epileptically activated areas.Case report: A 94-year-old woman presented with inability to communicate. An electroencephalogram revealed generalized periodic discharges with triphasic morphology. However, as her liver and kidney function were normal, it was difficult to distinguish metabolic encephalopathy from NCSE. ASL showed not only diffuse hypoperfusion in the cerebral parenchyma, instead of ictal hyperperfusion, but also marked appearance of arterial transit artifact in the major arteries, probably due to stagnant flow. The patient was therefore diagnosed with hyperammonemic encephalopathy (ammonia level 128 mg/dL) induced by constipation. Along with normalization of the ammonia level, the mental status and ASL findings improved.Conclusion: In this case, ASL helped visualize the decreased blood flow and velocity secondary to hypometabolism. The addition of ASL to conventional MR images may be useful in differentiating metabolic encephalopathy from NCSE, particularly in neuroemergency situations.
- 著者
- Yuichiro Tsurusaki Shota Sakai Takao Morita Kenji Miki Daisuke Inoue Sei Haga Shoji Arihiro
- 出版者
- The Japanese Society for Neuroendovascular Therapy
- 雑誌
- Journal of Neuroendovascular Therapy (ISSN:18824072)
- 巻号頁・発行日
- pp.cr.2022-0049, (Released:2022-08-20)
- 参考文献数
- 9
Objective: We report a case of huge scrotal hematoma during emergency mechanical thrombectomy.Case Presentation: An 85-year-old man presented with sudden aphasia and right-sided hemiplegia. He was diagnosed with cerebral infarction due to left M1 occlusion and underwent an emergency mechanical thrombectomy. The treatment was completed with full recanalization, but when replacing the long sheath in the right femoral artery with a short sheath, the patient flexed his leg. The sheath could not be replaced, resulting in a massive scrotal hematoma. Shortly after, the patient went into cardiopulmonary arrest but recovered spontaneous circulation after cardiopulmonary resuscitation. The puncture site was treated hemostatically with manual compression, and the scrotal hematoma was not enlarged. He was transferred to another hospital with a modified Rankin Scale score of 5.Conclusion: Scrotal hematoma is a rare but potentially fatal puncture site complication that should be considered during neuro-endovascular treatment.