Focal status epilepticus: follow-up by perfusion- and diffusion MRI.
Diffusion-weighted MRI demonstrated bright right temporoparietal cortex, right hippocampus, and left cerebellum in a 63-year-old female suffering a focal convulsive status epilepticus. Hyperperfusion was noted in the right temporoparietal region. Two days later, a tendency to normalization of most of the diffusion and perfusion changes was noted, apart from the right hippocampus which became brighter on diffusion- and T2-weighted images. On the tenth day the apparent diffusion coefficient was slightly elevated, getting brighter on T2-weighted images with suspected mild post-contrast enhancement. We postulate that the discharging right hippocampus suffered cytotoxic edema, which later progressed to cell damage.
El-Koussy
M
M
Department of Neuroradiology, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern, Switzerland. marwan.elkoussy@insel.ch
Mathis
J
J
Lövblad
K O
KO
Stepper
F
F
Kiefer
C
C
Schroth
G
G
D001921:Brain / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology; D004569:Electroencephalography; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010291:Paresis / Q000175:diagnosis; D013226:Status Epilepticus / Q000473:pathology*