PMID- 27486662
OWN - NLM
STAT- MEDLINE
DCOM- 20170802
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 8
DP  - 2016
TI  - Focal and Generalized Patterns of Cerebral Cortical Veins Due to Non-Convulsive 
      Status Epilepticus or Prolonged Seizure Episode after Convulsive Status 
      Epilepticus - A MRI Study Using Susceptibility Weighted Imaging.
PG  - e0160495
LID - 10.1371/journal.pone.0160495 [doi]
LID - e0160495
AB  - OBJECTIVE: The aim of this study was to investigate variant patterns of cortical 
      venous oxygenation during status epilepticus (SE) using susceptibility-weighted 
      imaging (SWI). METHODS: We analyzed magnetic resonance imaging (MRI) scans of 26 
      patients with clinically witnessed prolonged seizures and/or EEG-confirmed SE. 
      All MRI exams encompassed SWI, dynamic susceptibility contrast perfusion MRI 
      (MRI-DSC) and diffusion-weighted imaging (DWI). We aimed to identify distinct 
      patterns of SWI signal alterations that revealed regional or global increases of 
      cerebral blood flow (CBF) and DWI restrictions. We hypothesized that SWI-related 
      oxygenation patterns reflect ictal or postictal patterns that resemble SE or 
      sequelae of seizures. RESULTS: Sixteen patients were examined during 
      nonconvulsive status epilepticus (NCSE) as confirmed by EEG, a further ten 
      patients suffered from witnessed and prolonged seizure episode ahead of imaging 
      without initial EEG. MRI patterns of 15 of the 26 patients revealed generalized 
      hyperoxygenation by SWI in keeping with either global or multifocal cortical 
      hyperperfusion. Eight patients revealed a focal hyperoxygenation pattern related 
      to focal CBF increase and three patients showed a focal deoxygenation pattern 
      related to focal CBF decrease. CONCLUSIONS: SWI-related hyper- and deoxygenation 
      patterns resemble ictal and postictal CBF changes within a range from globally 
      increased to focally decreased perfusion. In all 26 patients the SWI patterns 
      were in keeping with ictal hyperperfusion (hyperoxygenation patterns) or 
      postictal hypoperfusion (deoxygenation patterns) respectively. A new finding of 
      this study is that cortical venous patterns in SWI can be not only focally, but 
      globally attenuated. SWI may thus be considered as an alternative contrast-free 
      MR sequence to identify perfusion changes related to ictal or postictal 
      conditions.
FAU - Verma, Rajeev Kumar
AU  - Verma RK
AD  - University Institute for Diagnostic and Interventional Neuroradiology, 
      Inselspital, University of Bern, Bern, Switzerland.
AD  - Institute of Radiology and Neuroradiology, Tiefenau Hospital, Bern, Switzerland.
FAU - Abela, Eugenio
AU  - Abela E
AD  - Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
FAU - Schindler, Kaspar
AU  - Schindler K
AD  - Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
FAU - Krestel, Heinz
AU  - Krestel H
AD  - Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
FAU - Springer, Elisabeth
AU  - Springer E
AD  - University Institute for Diagnostic and Interventional Neuroradiology, 
      Inselspital, University of Bern, Bern, Switzerland.
FAU - Huber, Adrian
AU  - Huber A
AD  - University Institute for Diagnostic and Interventional Radiology, Inselspital, 
      University of Bern, Bern, Switzerland.
FAU - Weisstanner, Christian
AU  - Weisstanner C
AD  - University Institute for Diagnostic and Interventional Neuroradiology, 
      Inselspital, University of Bern, Bern, Switzerland.
FAU - Hauf, Martinus
AU  - Hauf M
AD  - University Institute for Diagnostic and Interventional Neuroradiology, 
      Inselspital, University of Bern, Bern, Switzerland.
FAU - Gralla, Jan
AU  - Gralla J
AD  - University Institute for Diagnostic and Interventional Neuroradiology, 
      Inselspital, University of Bern, Bern, Switzerland.
FAU - Wiest, Roland
AU  - Wiest R
AD  - University Institute for Diagnostic and Interventional Neuroradiology, 
      Inselspital, University of Bern, Bern, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20160803
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Brain Mapping/methods
MH  - Cerebral Veins/*diagnostic imaging/physiopathology
MH  - *Cerebrovascular Circulation
MH  - Child
MH  - Child, Preschool
MH  - *Diffusion Magnetic Resonance Imaging
MH  - Electroencephalography
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Angiography
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Seizures/*diagnosis/*physiopathology
MH  - Status Epilepticus/*diagnosis/*physiopathology
MH  - Young Adult
PMC - PMC4972361
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2016/08/04 06:00
MHDA- 2017/08/03 06:00
PMCR- 2016/08/03
CRDT- 2016/08/04 06:00
PHST- 2016/04/02 00:00 [received]
PHST- 2016/07/20 00:00 [accepted]
PHST- 2016/08/04 06:00 [entrez]
PHST- 2016/08/04 06:00 [pubmed]
PHST- 2017/08/03 06:00 [medline]
PHST- 2016/08/03 00:00 [pmc-release]
AID - PONE-D-16-13276 [pii]
AID - 10.1371/journal.pone.0160495 [doi]
PST - epublish
SO  - PLoS One. 2016 Aug 3;11(8):e0160495. doi: 10.1371/journal.pone.0160495. 
      eCollection 2016.