tailieunhanh - báo cáo hóa học:" The role of perfusion CT in identifying stroke mimics in the emergency room: a case of status epilepticus presenting with perfusion CT alterations"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: The role of perfusion CT in identifying stroke mimics in the emergency room: a case of status epilepticus presenting with perfusion CT alterations | Guerrero et al. International Journal of Emergency Medicine 2012 5 4 http content 5 1 4 o International Journal of Emergency Medicine a SpringerOpen Journal CASE REPORT Open Access The role of perfusion CT in identifying stroke mimics in the emergency room a case of status epilepticus presenting with perfusion CT alterations Waldo R Guerrero Haitham Dababneh and Stephan Eisenschenk Abstract 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. Background The differentiation between stroke and seizure can be a clinically arduous task for both emergency medicine physicians and neurologists 1 2 . Patients with diseases that mimic stroke account for one-fifth of patients with brain attacks 1 . Imaging may therefore be critical in making a diagnosis in the acute setting. Seizure is one condition that can mimic a stroke. Commonly patients with Todd s paralysis or those with nonconvulsive status epilepticus can be clinically indistinct from those with acute stroke. Further complicating the clinical scenario seizure may also be a presenting sign of stroke 3 . Recently the time frame for standard treatment of acute stroke with IV tissue plasminogen activator was expanded from 3 h to h from ictus onset 4 . Although this extension of time is supported by the American Heart Association it is not FDA approved and comes with a different set of relative contraindications. Intravenous thrombolytics are not without the risk of complications including intracranial hemorrhage 5 . Non-contrast CT NCCT of the head is the current gold standard in excluding intracranial hemorrhage prior to administration .