Document Detail

Nonpulsatile cerebral perfusion in patient with acute neurological deficits.
MedLine Citation:
PMID:  16675733     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: An extremely low pulsatile cerebral perfusion can result in a massive cerebral infarction and poor outcome. We report a patient who had complete recovery from initial neurological deficits in spite of nonpulsatile perfusion in the middle cerebral artery. METHODS: We used carotid duplex and transcranial Doppler to evaluate cerebral hemodynamics and the National Institutes of Health Stroke Scale (NIHSS) to score the neurological deficits. RESULTS: A 62-year-old man had a sudden chest pain and right hemispheric symptoms with NIHSS score of 18 on arrival. Carotid duplex showed no blood flow in the right common carotid artery. Transcranial Doppler showed a nonpulsatile waveform with slow antegrade flow in right middle cerebral artery. Chest CT angiography revealed type A aortic dissection. After surgical repair for the aortic dissection with brain retroperfusion, the patient had dramatic recovery from the initial neurological deficit, and normal pulsatile cerebral perfusion in the right carotid territory. CONCLUSIONS: Nonpulsatile cerebral perfusion points to a proximal source of arterial flow obstruction that may necessitate interventional treatment or surgery in order to restore brain perfusion and potentially reverse impending stroke.
Yo Sik Kim; Oleg Y Chernyshev; Andrei V Alexandrov
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-05-04
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  37     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2006-06-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1562-4     Citation Subset:  IM    
Department of Neurology, Wonkwang University School of Medicine, Jeonbuk, Korea.
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MeSH Terms
Acute Disease
Aneurysm, Dissecting / complications*,  surgery
Aortic Aneurysm / complications*,  surgery
Middle Aged
Middle Cerebral Artery / physiopathology*
Nervous System Diseases / diagnosis,  etiology*,  physiopathology*
Recovery of Function
Regional Blood Flow
Tomography, X-Ray Computed
Ultrasonography, Doppler, Duplex
Ultrasonography, Doppler, Transcranial
Vascular Surgical Procedures*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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