Focal hemodynamic patterns of status epilepticus detected by susceptibility weighted imaging (SWI).

Aellen, Jerome; Abela, Eugenio; Bürki, Sarah Elisabeth; Kottke, Raimund; Springer, Elisabeth; Schindler, Kaspar Anton; Weisstanner, Christian; El-Koussy, Marwan; Schroth, Gerhard; Wiest, Roland; Gralla, Jan; Verma, Rajeev Kumar (2014). Focal hemodynamic patterns of status epilepticus detected by susceptibility weighted imaging (SWI). European radiology, 24(11), pp. 2980-2988. Springer 10.1007/s00330-014-3284-9

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OBJECTIVE To investigate pathological findings in the susceptibility weighted imaging (SWI) of patients experiencing convulsive (CSE) or non-convulsive status epilepticus (NCSE) with focal hyperperfusion in the acute setting. METHODS Twelve patients (six with NCSE confirmed by electroencephalogram (EEG) and six patients with CSE with seizure event clinically diagnosed) underwent MRI in this acute setting (mean time between onset of symptoms and MRI was 3 h 8 min), including SWI, dynamic susceptibility contrast MR imaging (DSC) and diffusion-weighted imaging (DWI). MRI sequences were retrospectively evaluated and compared with EEG findings (10/12 patients), and clinical symptoms. RESULTS Twelve out of 12 (100 %) patients showed a focal parenchymal area with pseudo-narrowed cortical veins on SWI, associated with focal hyperperfused areas (increased cerebral blood flow (CBF) and mean transit time (MTT) shortening), and cortical DWI restriction in 6/12 patients (50 %). Additionally, these areas were associated with ictal or postical EEG patterns in 8/10 patients (80 %). Most frequent acute clinical findings were aphasia and/or hemiparesis in eight patients, and all of them showed pseudo-narrowed veins in those parenchymal areas responsible for these symptoms. CONCLUSION In this study series with CSE and NCSE patients, SWI showed focally pseudo-narrowed cortical veins in hyperperfused and ictal parenchymal areas. Therefore, SWI might have the potential to identify an ictal region in CSE/NCSE. KEY POINTS • The focal ictal brain regions show hyperperfusion in DSC MR-perfusion imaging. • SWI shows focally diminished cortical veins in hyperperfused ictal regions. • SWI has the potential to identify a focal ictal region in CSE/NCSE.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Neuropaediatrics

UniBE Contributor:

Aellen, Jerome; Abela, Eugenio; Bürki, Sarah Elisabeth; Kottke, Raimund; Springer, Elisabeth; Schindler, Kaspar Anton; Weisstanner, Christian; El-Koussy, Marwan; Schroth, Gerhard; Wiest, Roland; Gralla, Jan and Verma, Rajeev Kumar

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0938-7994

Publisher:

Springer

Language:

English

Submitter:

Valentina Rossetti

Date Deposited:

13 Oct 2014 17:17

Last Modified:

29 Oct 2015 12:00

Publisher DOI:

10.1007/s00330-014-3284-9

PubMed ID:

25097124

BORIS DOI:

10.7892/boris.58187

URI:

https://boris.unibe.ch/id/eprint/58187

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