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Neuroradiology:高灌注引起的脑梗死?还是脑梗死后高灌注?

2019-05-31 佚名 脑血管病及重症文献导读

65岁,女性。既往高血压病史。因为突发表达性失语就诊,无其他神经功能缺损。

65岁,女性。

既往高血压病史。

因为突发表达性失语就诊,无其他神经功能缺损。

CT 未见颅内出血,CTA 未见血管闭塞。

CT 灌注显示左侧额叶皮层小片灌注异常,CBF 和 CBV增加,为高灌注表现(下图)。CTA(dynamic subtraction CTA rendering of CT perfusion)显示皮层静脉提前充盈(early contrast filling)。不除外动静脉分流:



随后头 MRI 显示相应区域弥散受限,符合缺血的表现(下图):



MRA 未见明显异常。

患者症状患者,随访也未发生其他新的症状。给予氯吡格雷和辛伐他汀治疗。

6周后随访4D-CT 未见任何异常,无 AV 分流的征象。

原始出处:Anna Koopman, Frank-Erik de Leeuw, Frederick Meijer. CT perfusion hypervolemia: brain ischemia or stroke mimic? Neuroradiology. April 2019

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    2024-05-25 ms4000001765327813 来自内蒙古

    没看懂,高灌注导致脑梗死,什么原因导致高灌注,发病是考虑动静脉畸形,后来否认动静脉畸形。脑梗死导致高灌注?再通了?

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2206561, encodeId=539322065615d, content=没看懂,高灌注导致脑梗死,什么原因导致高灌注,发病是考虑动静脉畸形,后来否认动静脉畸形。脑梗死导致高灌注?再通了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bb95612672, createdName=ms4000001765327813, createdTime=Sat May 25 18:44:34 CST 2024, time=2024-05-25, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=1951225, encodeId=f6ee19512259e, content=<a href='/topic/show?id=44fd10249309' target=_blank style='color:#2F92EE;'>#高灌注#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102493, encryptionId=44fd10249309, topicName=高灌注)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6779163, createdName=liuhuangbo, createdTime=Sun Dec 08 09:33:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465142, encodeId=33a51465142d7, content=<a href='/topic/show?id=2dea8489010' target=_blank style='color:#2F92EE;'>#脑梗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84890, encryptionId=2dea8489010, topicName=脑梗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccf56689148, createdName=karmond, createdTime=Sun Jun 02 06:33:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=367125, encodeId=80c536e125a6, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210319/8535b99e11f8425ea0d00535473afd64/2d2121d6fde646e4b4ea8d46ebb52b92.jpg, createdBy=e2423643634, createdName=133d9d3cm85暂无昵称, createdTime=Sat Jun 01 15:41:38 CST 2019, time=2019-06-01, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2206561, encodeId=539322065615d, content=没看懂,高灌注导致脑梗死,什么原因导致高灌注,发病是考虑动静脉畸形,后来否认动静脉畸形。脑梗死导致高灌注?再通了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bb95612672, createdName=ms4000001765327813, createdTime=Sat May 25 18:44:34 CST 2024, time=2024-05-25, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=1951225, encodeId=f6ee19512259e, content=<a href='/topic/show?id=44fd10249309' target=_blank style='color:#2F92EE;'>#高灌注#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102493, encryptionId=44fd10249309, topicName=高灌注)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6779163, createdName=liuhuangbo, createdTime=Sun Dec 08 09:33:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465142, encodeId=33a51465142d7, content=<a href='/topic/show?id=2dea8489010' target=_blank style='color:#2F92EE;'>#脑梗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84890, encryptionId=2dea8489010, topicName=脑梗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccf56689148, createdName=karmond, createdTime=Sun Jun 02 06:33:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=367125, encodeId=80c536e125a6, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210319/8535b99e11f8425ea0d00535473afd64/2d2121d6fde646e4b4ea8d46ebb52b92.jpg, createdBy=e2423643634, createdName=133d9d3cm85暂无昵称, createdTime=Sat Jun 01 15:41:38 CST 2019, time=2019-06-01, status=1, ipAttribution=)]
    2019-06-02 karmond
  4. [GetPortalCommentsPageByObjectIdResponse(id=2206561, encodeId=539322065615d, content=没看懂,高灌注导致脑梗死,什么原因导致高灌注,发病是考虑动静脉畸形,后来否认动静脉畸形。脑梗死导致高灌注?再通了?, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bb95612672, createdName=ms4000001765327813, createdTime=Sat May 25 18:44:34 CST 2024, time=2024-05-25, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=1951225, encodeId=f6ee19512259e, content=<a href='/topic/show?id=44fd10249309' target=_blank style='color:#2F92EE;'>#高灌注#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102493, encryptionId=44fd10249309, topicName=高灌注)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6779163, createdName=liuhuangbo, createdTime=Sun Dec 08 09:33:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465142, encodeId=33a51465142d7, content=<a href='/topic/show?id=2dea8489010' target=_blank style='color:#2F92EE;'>#脑梗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84890, encryptionId=2dea8489010, topicName=脑梗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccf56689148, createdName=karmond, createdTime=Sun Jun 02 06:33:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=367125, encodeId=80c536e125a6, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210319/8535b99e11f8425ea0d00535473afd64/2d2121d6fde646e4b4ea8d46ebb52b92.jpg, createdBy=e2423643634, createdName=133d9d3cm85暂无昵称, createdTime=Sat Jun 01 15:41:38 CST 2019, time=2019-06-01, status=1, ipAttribution=)]
    2019-06-01 133d9d3cm85暂无昵称

    学习了,谢谢

    0

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