Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompression
A 64-year-old woman presenting with subarachnoid hemorrhage (World Federation of Neurosurgeons grade IV) from the rupture of a right large internal carotid-posterior communicating artery aneurysm suffered neuronal damage associated with post-ischemic hyperperfusion after neck clipping of the aneurys...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014-09-01
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| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751914000358 |
| _version_ | 1818009911656710144 |
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| author | Yoshiteru Tada Junichiro Satomi Yasuhisa Kanematsu Kazuyuki Kuwayama Nobuhisa Matsushita Takashi Abe Masafumi Harada Shinji Nagahiro |
| author_facet | Yoshiteru Tada Junichiro Satomi Yasuhisa Kanematsu Kazuyuki Kuwayama Nobuhisa Matsushita Takashi Abe Masafumi Harada Shinji Nagahiro |
| author_sort | Yoshiteru Tada |
| collection | DOAJ |
| description | A 64-year-old woman presenting with subarachnoid hemorrhage (World Federation of Neurosurgeons grade IV) from the rupture of a right large internal carotid-posterior communicating artery aneurysm suffered neuronal damage associated with post-ischemic hyperperfusion after neck clipping of the aneurysm under suction decompression. She did not completely recover consciousness after the operation. Diffusion-weighted imaging (DWI) performed on the first postoperative day showed subtle cortical hyperintensity in the parietal lobe. Arterial spin-labeling (ASL) and 123I-iodoamphetamine (123I-IMP) single photon emission computed tomography (SPECT) demonstrated hyperperfusion in the right temporo-parietal lobes. Delayed 123I-iomazenil (123I-IMZ) SPECT images showed a reduced IMZ uptake in the right temporo-parietal lobe corresponding to the hyperperfusion area on ASL images. DWI repeated on postoperative day 3 revealed progression of a hyperintensity lesion in the right parietal lobe. Blood pressure control and the use of a free radical scavenger relieved her symptoms. One month later, the area of reduced IMZ uptake was further expanded. Our findings suggest that post-ischemic hyperperfusion after suction decompression may result in neuronal damage demonstrated on 123I-IMZ SPECT images. |
| first_indexed | 2024-04-14T05:48:49Z |
| format | Article |
| id | doaj.art-91046b426d6842b29ff4f78feebda0f6 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-04-14T05:48:49Z |
| publishDate | 2014-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-91046b426d6842b29ff4f78feebda0f62022-12-22T02:09:11ZengElsevierInterdisciplinary Neurosurgery2214-75192014-09-0113636510.1016/j.inat.2014.07.005Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompressionYoshiteru Tada0Junichiro Satomi1Yasuhisa Kanematsu2Kazuyuki Kuwayama3Nobuhisa Matsushita4Takashi Abe5Masafumi Harada6Shinji Nagahiro7Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, JapanDepartment of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, JapanDepartment of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, JapanDepartment of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, JapanDepartment of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, JapanDepartment of Radiology, School of Medicine, The University of Tokushima, Tokushima City, JapanDepartment of Radiology, School of Medicine, The University of Tokushima, Tokushima City, JapanDepartment of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, JapanA 64-year-old woman presenting with subarachnoid hemorrhage (World Federation of Neurosurgeons grade IV) from the rupture of a right large internal carotid-posterior communicating artery aneurysm suffered neuronal damage associated with post-ischemic hyperperfusion after neck clipping of the aneurysm under suction decompression. She did not completely recover consciousness after the operation. Diffusion-weighted imaging (DWI) performed on the first postoperative day showed subtle cortical hyperintensity in the parietal lobe. Arterial spin-labeling (ASL) and 123I-iodoamphetamine (123I-IMP) single photon emission computed tomography (SPECT) demonstrated hyperperfusion in the right temporo-parietal lobes. Delayed 123I-iomazenil (123I-IMZ) SPECT images showed a reduced IMZ uptake in the right temporo-parietal lobe corresponding to the hyperperfusion area on ASL images. DWI repeated on postoperative day 3 revealed progression of a hyperintensity lesion in the right parietal lobe. Blood pressure control and the use of a free radical scavenger relieved her symptoms. One month later, the area of reduced IMZ uptake was further expanded. Our findings suggest that post-ischemic hyperperfusion after suction decompression may result in neuronal damage demonstrated on 123I-IMZ SPECT images.http://www.sciencedirect.com/science/article/pii/S2214751914000358HyperperfusionNeuronal damageSuction decompression |
| spellingShingle | Yoshiteru Tada Junichiro Satomi Yasuhisa Kanematsu Kazuyuki Kuwayama Nobuhisa Matsushita Takashi Abe Masafumi Harada Shinji Nagahiro Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompression Interdisciplinary Neurosurgery Hyperperfusion Neuronal damage Suction decompression |
| title | Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompression |
| title_full | Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompression |
| title_fullStr | Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompression |
| title_full_unstemmed | Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompression |
| title_short | Post-ischemic hyperperfusion after clipping of a ruptured internal carotid-posterior communicating artery aneurysm under suction decompression |
| title_sort | post ischemic hyperperfusion after clipping of a ruptured internal carotid posterior communicating artery aneurysm under suction decompression |
| topic | Hyperperfusion Neuronal damage Suction decompression |
| url | http://www.sciencedirect.com/science/article/pii/S2214751914000358 |
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