Long-Term Follow Up of Patients With Good Outcome After Intra-arterial Thrombolysis for Major Arterial Occlusion in the Carotid Territory: Clinical and Magnetic Resonance Imaging Evaluation

• SORIMACHI Takatoshi

  Department of Neurosurgery, Nishiogi-chuo Hospital

• ITO Yasushi

  Department of Neurosurgery, Brain Research Institute, University of Niigata

• MORITA Kenichi

  Department of Neurosurgery, Nishiogi-chuo Hospital

• FUJII Yukihiko

  Department of Neurosurgery, Brain Research Institute, University of Niigata

抄録

Long-term clinical symptoms, including extrapyramidal signs, and magnetic resonance (MR) imaging studies were retrospectively analyzed in 21 patients with good outcome (modified Rankin scale scores 0-2) after successful recanalization of occluded major arteries by intra-arterial thrombolysis with mechanical disruption. Changes in high intensity areas (HIAs) and cerebral atrophy in the ischemic hemisphere were evaluated on follow-up fluid-attenuated inversion recovery MR images. Extrapyramidal signs, short-stepped gait and/or masked face, were observed in 12 of 21 patients during the follow-up period (11 to 68 months, mean 42 months). Enlargement of HIA was demonstrated in 10 of 18 patients undergoing follow-up MR imaging. Cerebral atrophy in the ischemic hemisphere was revealed on the follow-up MR images in all 18 patients. In nine patients with small infarctions, 20 ml or less on computed tomography scans, cerebral atrophy progressed more rapidly in four patients with extrapyramidal signs compared to the other five patients without extrapyramidal signs (p < 0.05). More than half of the patients with good outcome showed extrapyramidal signs. Extrapyramidal signs in patients with small infarction may indicate rapid progression of cerebral atrophy. The occurrence of extrapyramidal signs might be related to delayed neuronal death in atrophic areas.<br>

収録刊行物

• Neurologia medico-chirurgica

  Neurologia medico-chirurgica 50 (1), 13-19, 2010

  一般社団法人 日本脳神経外科学会

キーワード

• cerebral infarction
• extrapyramidal symptom
• internal carotid artery occlusion
• middle cerebral artery occlusion
• vascular parkinsonism

詳細情報

• CRID: 1390282680034883200
• NII論文ID: 10025949760
• NII書誌ID: AN00358613
• DOI: 10.2176/nmc.50.13
• ISSN: 13498029
• ISSN: 04708105
• Web Site: http://www.jstage.jst.go.jp/article/nmc/50/1/50_1_13/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2010139443
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可