| Prolonged unilateral vasodilatation and brain edema in fulminant hepatic failure, associated with symptomatic seizure. | |
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MedLine Citation:
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PMID: 11932048 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report prolonged unilateral vasodilatation and hemispheric brain edema in a 49-year-old man with fulminant hepatic failure (FHF). The patient presented with a tonic-clonic seizure caused by a hypertensive subcortical hemorrhage in the left parietal lobe. Serial computed tomography (CT) scans showed progressive darkening of the ipsilateral hemisphere, suggesting hemispheric cerebral infarction, but the patient did not show clinical signs of deterioration. Brain magnetic resonance angiography showed dilation of the large arteries of the left hemisphere. Evaluation of cerebral blood flow 7 days postictus with single photon emission CT revealed marked ipsilateral hyperperfusion. The darkening of the hemisphere was brain edema elicited by hyperperfusion. Brain edema was reversible, disappearing 14 days postictus. Hemispheric brain edema was caused by unilateral cerebral vasodilatation and resultant hyperperfusion. Although brain edema is a major complication in FHF patients and cerebral hyperperfusion is responsible for edema formation, CT findings of these patients almost invariably show a bilateral lesion. Unilateral vasodilatation and subsequent hemispheric hyperperfusion may be due to overproduction of vasodilators, already abundant in the brains of patients with severe hepatic failure, by seizure activity. |
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Authors:
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Joji Inamasu; Yoshiki Nakamura; Shinichiro Yamamoto; Namiko Sakamoto; Ryoichi Saito; Takashi Horiguchi; Kiyoshi Ichikizaki |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Clinical neurology and neurosurgery Volume: 104 ISSN: 0303-8467 ISO Abbreviation: Clin Neurol Neurosurg Publication Date: 2002 May |
Date Detail:
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Created Date: 2002-04-04 Completed Date: 2002-07-17 Revised Date: 2009-10-14 |
Medline Journal Info:
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Nlm Unique ID: 7502039 Medline TA: Clin Neurol Neurosurg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 157-60 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, National Tokyo Medical Center, Higashigaoka 2-5-1, Meguro-ku, Tokyo 152-8902, Japan. ginamasu@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Brain
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blood supply* Brain Edema / etiology* Humans Liver Failure / complications* Magnetic Resonance Angiography Male Middle Aged Regional Blood Flow Seizures / etiology* Tomography, X-Ray Computed Vasodilation* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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