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Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
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Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...
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Cerebral perfusion-CT patterns following seizure.

J M Gelfand1, M Wintermark, S A Josephson

  • 1Department of Neurology, Neuroradiology Section, University of California, San Francisco, CA 94143-0114, USA.

European Journal of Neurology
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Post-ictal cerebral perfusion-CT (PCT) abnormalities are common in patients shortly after seizure. Imaging within 2 hours of seizure termination increases the likelihood of detecting these perfusion changes.

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Cerebral perfusion-CT (PCT) is a standard tool for stroke assessment.
  • PCT may also reveal abnormalities after seizures.

Purpose of the Study:

  • To investigate the utility of PCT in detecting post-ictal abnormalities.
  • To compare PCT findings in patients with normal vs. abnormal post-ictal scans.

Main Methods:

  • Retrospective analysis of 27 patients with seizure-related neurological deficits.
  • PCT imaging performed within 72 hours of seizure.
  • Exclusion of patients with seizures secondary to acute processes.

Main Results:

  • 37% of patients showed abnormal post-ictal PCT.
  • Focal hypoperfusion was the most common abnormality (8/10 patients).
  • Abnormalities were more likely when imaging occurred within 2 hours of seizure.

Conclusions:

  • Post-ictal PCT abnormalities are frequent in the early period after seizure.
  • Atypical perfusion patterns on PCT, without large vessel occlusion on CTA, suggest seizure as a diagnosis.
  • Consider seizure in differential diagnosis before acute stroke therapy when PCT findings are unusual.