J Korean Soc Radiol.  2013 Aug;69(2):89-92. 10.3348/jksr.2013.69.2.89.

Regional Cortical Hyperperfusion on Perfusion CT during Postictal Motor Deficit: A Case Report

• Baek HJ

• KMID: 2208810
• DOI: http://doi.org/10.3348/jksr.2013.69.2.89

Abstract

Postictal neurologic deficit is a well-known complication mimicking the manifestation of a stroke. We present a case of a patient with clinical evidence of Todd's paralysis correlating with reversible postictal parenchymal changes on perfusion CT and magnetic resonance (MR) imaging. In this case, perfusion CT and MR imaging were helpful in the differential diagnosis of stroke-mimicking conditions.

MeSH Terms

Diagnosis, Differential
Humans
Magnetic Resonance Spectroscopy
Neurologic Manifestations
Paralysis
Perfusion
Stroke

Figure

• 

  Fig. 1 A 72-year-old male with acute onset aphasia and right extremity weakness. A. Axial DWI shows subtle cortical hyperintensity in the left parietal lobe. B. ADC reveals mild diffusion restriction. C-E. Perfusion CT images demonstrate increased CBF (C) and CBV (D) in the left parietal cortices, but relatively normal configuration of MTT (E). F, G. Axial CTA source images demonstrates mild increased vascular pattern. H. Follow-up DWI on the next day shows no diffusion abnormality. I, J. Follow-up perfusion CT at one week shows complete normalization of the preexisting hyperperfusion on CBF (I) and CBV (J) maps. Note.-ADC = apparent diffusion coefficient, CBF = cerebral blood flow, CBV = cerebral blood volume, CTA = CT angiography, DWI = diffusion-weighted image, MTT = mean transition time

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