The role of perfusion CT in identifying stroke mimics in the emergency room: A case of status epilepticus presenting with perfusion CT alterations

被引：13

作者：

Waldo R Guerrero

Haitham Dababneh

Stephan Eisenschenk

机构：

[1] Department of Neurology, College of Medicine, University of Florida, Gainesville, 32610-0236 FL

来源：

International Journal of Emergency Medicine | / 5卷 / 1期

关键词：

Status Epilepticus; Acute Stroke; Cerebral Blood Volume; Mean Transit Time; Fosphenytoin;

D O I：

10.1186/1865-1380-5-4

中图分类号：

学科分类号：

摘要：

Emergency medicine physicians are often faced with the challenging task of differentiating true acute ischemic strokes from stroke mimics. We present a case that was initially diagnosed as acute stroke. However, perfusion CT and EEG eventually led to the final diagnosis of status epilepticus. This case further asserts the role of CT perfusion in the evaluation of patients with stroke mimics in the emergency room setting. © 2012 Guerrero et al.

引用

共 18 条

[1]

Davis D.P., Robertson T., Imbesi S.G., Diffusion-weighted magnetic resonance imaging versus computed tomography in the diagnosis of acute ischemic stroke, Journal of Emergency Medicine, 31, 3, pp. 269-277, (2006)

[2]

Scott P.A., Silbergleit R., Misdiagnosis of stroke in tissue plasminogen activator-treated patients: Characteristics and outcomes, Annals of Emergency Medicine, 42, 5, pp. 611-618, (2003)

[3]

Selim M., Kumar S., Fink J., Schlaug G., Caplan L.R., Linfante I., At Stroke S., Onset: Is it an absolute contraindication to thrombolysis, Cerebrovasc Dis, 14, pp. 54-57, (2002)

[4]

Hacke W., Kaste M., Bluhmki E., Brozman M., Davalos A., Guidetti D., Larrue V., Lees K.R., Medeghri Z., MacHnig T., Schneider D., Von Kummer R., Wahlgren N., Toni D., ECASS Investigators: Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke, N Engl J Med, 359, 13, pp. 1317-1329, (2008)

[5]

The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group: Tissue plasminogen activator for acute ischemic stroke, N Engl J Med, 333, pp. 1581-1587, (1995)

[6]

Wintermark M., Flanders A.E., Velthuis B., Meuli R., Van Leeuwen M., Goldsher D., Pineda C., Serena J., Van Der Schaaf I., Waaijer A., Anderson J., Nesbit G., Gabriely I., Medina V., Quiles A., Pohlman S., Quist M., Schnyder P., Bogousslavsky J., Dillon W.P., Pedraza S., Perfusion-CT assessment of infarct core and penumbra: Receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke, Stroke, 37, 4, pp. 979-985, (2006)

[7]

Murphy B.D., Fox A.J., Lee D.H., Sahlas D.J., Black S.E., Hogan M.J., Coutts S.B., Demchuk A.M., Goyal M., Aviv R.I., Symons S., Gulka I.B., Beletsky V., Pelz D., Hachinski V., Chan R., Lee T.-Y., Identification of penumbra and infarct in acute ischemic stroke using computed tomography perfusion-derived blood flow and blood volume measurements, Stroke, 37, 7, pp. 1771-1777, (2006)

[8]

Hacke W., Kaste M., Fieschi C., Von Kummer R., Davalos A., Meier D., Larrue V., Bluhmki E., Davis S., Donnan G., Schneider D., Diez-Tejedor E., Trouillas P., Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II), Lancet, 352, 9136, pp. 1245-1251, (1998)

[9]

Hemmen T.M., Meyer B.C., McClean T.L., Lyden P.D., Identification of nonischemic stroke mimics among 411 code strokes at the university of california san Diego, stroke center, J Stroke Cerebrovasc Dis, 17, 1, pp. 23-25, (2008)

[10]

Hand P.J., Kwan J., Lindley R.I., Dennis M.S., Wardlaw J.M., Distinguishing between stroke and mimics at the bedside, Stroke, 37, pp. 769-775, (2006)

← 1 2 →