Large Artery Occlusive Disease of the Anterior Circulation

Caplan, Louis R.

doi:10.1016/b978-1-4160-4721-6.50008-0

Cited by 2 publications

(2 citation statements)

References 200 publications

(213 reference statements)

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“…In addition, there were no signs of acute ischemia involving the caudate and adjacent regions such as contralateral hemiparesis, dysarthria, behavioral changes (e.g., abulia, slowness of thought, or restlessness/agitation), or choreoathetosis. 10 The postoperative depression with anxiety in the patient in case 1 was dissimilar to these behavioral changes and can be explained by the alternative psychosis. Furthermore, ischemic lesions show more or less edema unless the image was taken in the hyperacute period, and they also develop residual T2-FLAIR hyperintensity or a cavitary change in the chronic period.…”

Section: Discussionmentioning

confidence: 94%

Postoperative striatal degeneration: a hitherto unrecognized impact of frontal disconnection surgery for drug-resistant epilepsy. Illustrative cases

Hagiwara

Tanaka²,

Miyoshi

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Frontal disconnection surgery is a useful surgical option for patients with frontal epilepsy whose seizure onset zones are exceedingly large and thus are not amenable to conventional resective surgery. While it has the advantage of avoiding sequelae stemming from a large resection cavity, the impact of radical anatomofunctional disconnection of such a vast frontal region is not fully understood. OBSERVATIONS The authors have identified secondary degeneration in the striatum ipsilateral to the frontal disconnection surgery in two adult patients who had otherwise favorable postoperative outcomes following the surgery. On serial postoperative magnetic resonance imaging, the striatum showed transient restricted diffusion in the caudate head and rostral putamen around several weeks postoperatively and subsequent atrophy in the caudate head. The affected striatal regions (i.e., the anterior portion of the striatum) were congruent with the known fronto-striatal connectivity corresponding to the disconnected frontal regions anterior to the primary and supplementary motor areas. Both patients achieved 1-year seizure freedom without apparent disability related to the surgery. LESSONS The benign postoperative course despite the marked degenerative changes in the ipsilateral striatum supports the feasibility of the frontal disconnection surgery in otherwise inoperable patients with broad frontal epileptogenicity.

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Section: Discussionmentioning

confidence: 94%

Postoperative striatal degeneration: a hitherto unrecognized impact of frontal disconnection surgery for drug-resistant epilepsy. Illustrative cases

Hagiwara

Tanaka²,

Miyoshi

et al. 2022

Journal of Neurosurgery: Case Lessons

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“…Recent advances in thrombolytic therapy and acute vascular imaging provided unique opportunities to directly link patient symptoms to pathophysiology of brain perfusion changes early in the course of cerebral ischemia. For instance, acute proximal intracranial occlusions can present with a variety of clinical symptoms and a broad range of stroke severity . Isolated central facial palsy (I‐CFP) was commonly attributed to lacunar lesions present in corona radiata, internal capsule, and pons .…”

Section: Introductionmentioning

confidence: 99%

Acute Isolated Central Facial Palsy as Manifestation of Middle Cerebral Artery Ischemia

Sands

Shahripour

Kumar

et al. 2016

Journal of Neuroimaging

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Contrary to current teaching of lesion localization for an I-CFP, our study revealed the majority of acute patients presenting with this symptom had evidence of flow-limiting thromboembolic MCA disease rather than a lacunar lesion. Our findings underscore the essential role of comprehensive vascular imaging in patients presenting with I-CFP, which is commonly associated with acute flow-limiting thromboembolic MCA disease.

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Large Artery Occlusive Disease of the Anterior Circulation

Cited by 2 publications

References 200 publications

Postoperative striatal degeneration: a hitherto unrecognized impact of frontal disconnection surgery for drug-resistant epilepsy. Illustrative cases

Postoperative striatal degeneration: a hitherto unrecognized impact of frontal disconnection surgery for drug-resistant epilepsy. Illustrative cases

Acute Isolated Central Facial Palsy as Manifestation of Middle Cerebral Artery Ischemia

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