- 著者
- Masayuki Ueda Marie Tsunogae Hiroshi Saito Takeya Suzuki Takahiro Ota
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.5621-20, (Released:2020-09-19)
- 参考文献数
- 14
- 被引用文献数
- 4
A 24-year-old female patient was admitted for a right frontal intracranial hematoma with an uncal herniation due to a ruptured arteriovenous malformation and therefore underwent emergency surgery. Neuroimaging revealed left-sided midbrain notching against the tentorium, indicating Kernohan's notch phenomenon. She denied experiencing any short-term neurological deficits but right-sided delayed hemiparkinsonism developed 18 months later. Dopamine transporter tracer uptake was severely reduced in the left striatum, suggesting nigrostriatal degeneration secondary to Kernohan's notch. Uncal herniations are potentially fatal, but surgery can save the patient's life and improve the functional outcomes. Clinicians should therefore be aware of delayed hemiparkinsonism as a rare complication of Kernohan's notch phenomenon.
- 著者
- Hiroto Kano Akira Koike Masayo Hoshimoto-Iwamoto Osamu Nagayama Koji Sakurada Takeya Suzuki Hidekazu Tsuneoka Hitoshi Sawada Tadanori Aizawa Karlman Wasserman
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.1111011451, (Released:2011-11-16)
- 参考文献数
- 23
- 被引用文献数
- 13 11
Background: The aim of the present study was to compare the end-tidal O2 pressure (PETO2) to end-tidal CO2 pressure (PETCO2) in cardiac patients during rest and during 2 states of exercise: at anaerobic threshold (AT) and at peak. The purpose was to see which metabolic state, PETO2 or PETCO2, best correlated with exercise limitation. Methods and Results: Thirty-eight patients with left ventricular (LV) ejection fraction <40% underwent cardiopulmonary exercise testing (CPX). PETO2 and PETCO2 were measured during CPX, along with peak O2 uptake (VO2), AT, slope of the increase in ventilation (VE) relative to the increase in CO2 output (VCO2) (VE vs. VCO2 slope), and the ratio of the increase in VO2 to the increase in work rate (ΔVO2/ΔWR). Both PETO2 and PETCO2 measured at AT were best correlated with peakVO2, AT, ΔVO2/ΔWR and VE vs. VCO2 slope. PETO2 at AT correlated with reduced peak VO2 (r=-0.60), reduced AT (r=-0.52), reduced ΔVO2/ΔWR (r=-0.55) and increased VE vs. VCO2 slope (r=0.74). PETCO2 at AT correlated with reduced peak VO2 (r=0.67), reduced AT (r=0.61), reduced ΔVO2/ΔWR (r=0.58) and increased VE vs. VCO2 slope (r=-0.80). Conclusions: PETCO2 and PETO2 at AT correlated with peak VO2, AT and ΔVO2/ΔWR, but best correlated with increased VE vs. VCO2 slope. PETO2 and PETCO2 at AT can be used as a prime index of impaired cardiopulmonary function during exercise in patients with LV failure.