Cerebral Hypoperfusion in Posterior Reversible Encephalopathy Syndrome is Different from Transient Ischemic Attack on CT Perfusion.

Details

Serval ID
serval:BIB_7A97FA3122EE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cerebral Hypoperfusion in Posterior Reversible Encephalopathy Syndrome is Different from Transient Ischemic Attack on CT Perfusion.
Journal
Journal of neuroimaging : official journal of the American Society of Neuroimaging
Author(s)
Vanacker P., Matias G., Hagmann P., Michel P.
ISSN
1552-6569 (Electronic)
ISSN-L
1051-2284
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
25
Number
4
Pages
643-646
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication types: Journal Article ; Research Support, Non-U.S. Gov't

Abstract
PRES is a reversible neurotoxic state presenting with headache, altered mental status, visual loss, and seizures. Delayed diagnosis can be avoided if radiological patterns could distinguish PRES from cerebral ischemia.
Clinical and radiological data were collected on all hospitalized patients who had (1) discharge diagnosis of PRES and (2) acute CTP/CTA. Data were compared with 10 TIA patients with proven cytotoxic edema on MRI.
Of the four PRES patients found, three were correlated with acute blood pressure and one with chemotherapy. At the radiological level, quantitative analyses of the CTP parameters showed that 2 out of 4 patients had bilaterally reduced CBF-values (23.2-47.1 ml/100g/min) in occipital regions, as seen in the pathological regions of TIA patients (27.3 ± 13.5 ml/100g/min). When compared with TIA patients, the pathological ROI's demonstrated decreased CBV-values (3.4-5.6 ml/100g). Vasogenic edema on MRI FLAIR imaging was seen in only one PRES patient, and cytotoxic edema on DWI-imaging was never found. CT angiography showed in one PRES patient a vasospasm-like unilateral posterior cerebral artery.
If confirmed by other groups, CTP and CTA imaging in patients with acute visual loss and confusion may help to distinguish PRES from bi-occipital ischemia. These radiological parameters may identify PRES patients at risk for additional tissue infarction.

Keywords
Aged, Brain Ischemia/etiology, Brain Ischemia/physiopathology, Brain Ischemia/radiography, Cerebral Angiography/methods, Cerebrovascular Circulation, Diagnosis, Differential, Female, Humans, Ischemic Attack, Transient/physiopathology, Ischemic Attack, Transient/radiography, Male, Posterior Leukoencephalopathy Syndrome/complications, Posterior Leukoencephalopathy Syndrome/physiopathology, Posterior Leukoencephalopathy Syndrome/radiography, Reproducibility of Results, Sensitivity and Specificity, Tomography, X-Ray Computed/methods
Pubmed
Create date
15/10/2014 14:35
Last modification date
20/08/2019 15:36
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