Document Detail


Multidetector Computed Tomography Angiography to Detect the Cause of Multiple Brain Infarctions.
MedLine Citation:
PMID:  25304724     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Multidetector computed tomography angiography (MDCTA) is useful to inspect cardiovascular pathologic changes with minimal invasiveness. Here we evaluated the usefulness of MDCTA to determine the cause of acute multiple brain infarction (AMBI).
METHODS: AMBI was defined as multiple recent infarcts demonstrated on diffusion-weighted imaging. A new infarction within 2 weeks from the last was also considered an AMBI.
RESULTS: Between January 2012 and December 2013, 967 patients were diagnosed with acute brain infarction and 138 (14.3%) with AMBI. Among them, 57 (39 men and 18 women; age, 38-93 years) were examined by MDCTA using the dual-phase method. All images were diagnostic, even if patients found it difficult to hold their breath. Fifteen patients (26.3%) were diagnosed with patent foramen ovale (PFO). Two had complications of atrial fibrillation (AF), necessitating anticoagulant therapy (ACT). Four had both PFO and severe aortic atherosclerotic plaque formation, necessitating single antiplatelet therapy (APT) and/or ACT. Fifteen patients (26.3%) developed complicated arterial plaques around the aortic arch and were administered single or dual APT and/or ACT, except 1 patient with a history of multiple cerebral bleeding. Nine patients had pre-existing AF. Furthermore, ACT was initiated for 2 other patients with thrombus or circulatory stasis in the left atrial appendage despite normal electrocardiographic findings. Two other patients were diagnosed with advanced cancer, which was considered Trousseau syndrome. The cause of AMBI was determined in 36 (63.2%) patients.
CONCLUSIONS: MDCTA is a useful and less invasive method to identify the cause of embolic infarction.
Authors:
Sanami Kawada; Toshikazu Hamaguchi; Michio Kitayama; Takaki Imamura; Manabu Ohno; Kenichi Kashihara; Kouichiro Iwasaki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-7
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  -     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-11     Completed Date:  -     Revised Date:  2014-10-12    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
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