Various pathophysiological mechanisms of Todd’s palsy revealed by 1.5-Tesla magnetic resonance imaging including arterial spin labeling perfusion imaging during neurological emergencies
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- Morioka Takato
- Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
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- Inoha Satoshi
- Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
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- Mugita Fumihito
- Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
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- Yokomizo Akifumi
- Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
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- Akiyama Tomoaki
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
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- Shimogawa Takafumi
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
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- Mukae Nobutaka
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
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- Sakata Ayumi
- Department of Clinical Laboratory, Kyushu University Hospital, Fukuoka, Fukuoka, Japan Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
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- Shigeto Hiroshi
- Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
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- Yoshimoto Koji
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
説明
<p>Although Todd’s palsy is a well-known pathological condition, its pathophysiological mechanisms remain unclear. We evaluated two patients using magnetic resonance imaging (MRI), including 1.5-Tesla pseudo-continuous arterial spin labeling (ASL) perfusion imaging, to observe ictal hyperperfusion and associated hemodynamic changes in the peri-rolandic region. In Patient 1, marked ictal ASL hyperperfusion and cytotoxic edema were observed in the interhemispheric cortex of the right peri-rolandic region. Persistence of this edema was associated with left leg palsy lasting 25 days. In Patient 2, prominent ictal ASL hyperperfusion was observed in the right parieto-occipito-temporal lobes without direct involvement of the precentral gyrus. The palsy and MRI findings improved within one day and on Day 4, respectively. We speculate the palsy was caused by transient hypoperfusion of the precentral gyrus, resulting from blood stealing by ictal hyperperfusion. Todd’s palsy may involve various pathophysiological conditions, and combined use of MRI including ASL and electroencephalography is useful in diagnosing this pathophysiology.</p>
収録刊行物
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- Epilepsy & Seizure
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Epilepsy & Seizure 17 (0), n/a-, 2025
一般社団法人 日本てんかん学会
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キーワード
詳細情報 詳細情報について
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- CRID
- 1390023461082084864
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- ISSN
- 18825567
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- 本文言語コード
- en
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- データソース種別
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- JaLC
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- 抄録ライセンスフラグ
- 使用不可