Acute cerebral ischemia following intraventricular hemorrhage in moyamoya disease: early perfusion computed tomography findings.
The authors present a rare case of an infarction complication 15 days following acute intraventricular bleeding due to moyamoya disease. Before the infarction occurred, perfusion CT imaging disclosed early but reversible ischemic injury on the day of hemorrhage. Dehydration and hypotension are both possibly contributing factors of progressive injury from reversible ischemia due to infarction. Although the patient underwent successful bypass surgery, 1 month after the ictus the neurobehavior evaluation still showed marked executive dysfunction. The authors address that, in hemorrhagic-type moyamoya disease, early perfusion CT scanning is not only a powerful tool to identify the high-risk group of patients who could experience subacute infarction, but also alarms neurosurgeons to eliminate any predisposing factors when it shows reversible ischemic injuries.
Su
I-Chang
IC
Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Yang
Chi-Cheng
CC
Wang
Wei-Han
WH
Lee
Jing-Er
JE
Tu
Yong-Kwang
YK
Wang
Kuo-Chuan
KC
D000208:Acute Disease; D000328:Adult; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000209:etiology*; D003681:Dehydration / Q000150:complications; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000150:complications; D009072:Moyamoya Disease / Q000150:complications*; D011237:Predictive Value of Tests; D012307:Risk Factors; D014057:Tomography, X-Ray Computed