RESUMO
A large ductus arteriosus aneurysm can lead to potentially serious and life-threatening complications. We report a case of aneurysmal dilatation of the ductus arteriosus in a premature infant that was successfully treated with indomethacin. Thus, surgical intervention with general anesthesia could be avoided.
Assuntos
Aneurisma/congênito , Permeabilidade do Canal Arterial/tratamento farmacológico , Canal Arterial/anormalidades , Indometacina/uso terapêutico , Doenças do Prematuro/tratamento farmacológico , Aneurisma/diagnóstico por imagem , Aneurisma/tratamento farmacológico , Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/diagnóstico por imagem , Ecocardiografia/efeitos dos fármacos , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico por imagem , Masculino , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/tratamento farmacológicoRESUMO
BACKGROUND: Diagnosis of cerebral venous thrombosis (CVT) is usually achieved by digital subtraction angiography or magnetic resonance angiography, while structural brain tissue damage can be assessed by computed tomography or magnetic resonance imaging (MRI). Using perfusion and diffusion weighted imaging (PWI, DWI) we aimed in this study to identify pathophysiological patterns corresponding to only functional and hence reversible tissue involvement. METHODS: PWI, DWI, and conventional MRI were performed in six CVT patients acutely and after 16-26 days when their clinical condition had improved. All patients were treated with partial thromboplastin time-effective intravenous heparin. After intravenous administration of a paramagnetic contrast agent, bolus track PWI allows pixel based determination of mean transit time (MTT) and cerebral blood volume (CBV). DWI was performed with two different b values (0, 1000 s/mm2) for calculation of apparent diffusion coefficient (ADC) maps. RESULTS: In five of six cases increased MTT values were observed initially, whereas the CBV was normal, indicating a reduction of cerebral blood flow. ADC values were normal. On follow up after clinical recovery MTT prolongations had resolved. Areas with prolonged MTT did not evolve into structural lesions. CONCLUSION: In patients with CVT, prolongations of MTT in the absence of changes in CBV and ADC seem to indicate reversible involvement of brain tissue, a situation corresponding to the ischaemic penumbra.
Assuntos
Trombose Intracraniana/patologia , Trombose Venosa/patologia , Adulto , Anticoagulantes/uso terapêutico , Isquemia Encefálica , Córtex Cerebral/irrigação sanguínea , Feminino , Heparina/uso terapêutico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo RegionalRESUMO
Six patients who had suffered small cerebral ischemia affecting subcortical gray matter were examined with diffusion weighted imaging (DWI) and T2-weighted imaging within the first 8 h, during the next 2 days and after 5-16 days. Areas of apparent diffusion coefficient (ADC) decreases were observed acutely and reached the maximum size during the subsequent 2 days. Noticeably, in all subjects, a large portion of the ADC lesion was reversible as judged from the lesion size on final T2 image. The regular reversibility of the ADC decreases in this setting may indicate a hitherto not understood pathophysiological process occurring in small ischemic stroke.
