Post-ictal hypoperfusion detected by CT Perfusion

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dc.contributor.advisorFederico, Paolo
dc.contributor.authorLi, Emmy
dc.contributor.committeememberTeskey, Gordon Campbell
dc.contributor.committeememberLee, Ting Yim
dc.contributor.committeememberMenon, Bijoy K.
dc.date2018-11
dc.date.accessioned2018-05-09T17:34:37Z
dc.date.available2018-05-09T17:34:37Z
dc.date.issued2018-05-07
dc.description.abstractBackground: Seizures are often followed by a period of transient neurological dysfunction whereby sensory, cognitive, or motor abilities are impaired. Alterations in cerebral blood flow (CBF) during the postictal period has been proposed as a possible mechanism for this phenomenon. Recent animal studies have shown reduced local CBF at the seizure onset zone (SOZ) lasting up to one hour following seizures (Farrell, et al., 2016). Using arterial spin labeling magnetic resonance imaging (ASL MRI), we have observed postictal hypoperfusion at the SOZ in 75% of patients lasting up to one hour (Gaxiola-Valdez, 2017). The clinical implementation of ASL as a novel tool to identify the SOZ is hampered by the limited availability of MRI on short notice. Computed tomography perfusion (CTP) also measures CBF changes and may circumvent the logistical limitations of MRI. Methods: Fifteen patients with drug resistant focal epilepsy admitted for pre-surgical evaluation were prospectively recruited and underwent CTP scanning within 80 min of a habitual seizure. Patients underwent a second scan in the interictal period after they were seizure-free for at least 24 hours. The acquired scans were visually assessed for perfusion differences and quantitatively assessed to identify areas of significant postictal hypoperfusion. Results: Postictal reductions of >15 CBF units (ml/100g-1/min-1) were seen in 12/15 patients. In 10 of these patients, the location of the hypoperfusion was partially or fully concordant with the presumed SOZ, and all patients localized additional areas of seizure propagation concordant with their electroencephalography (EEG). Conclusions: Postictal hypoperfusion can be measured by CTP. Thus, CTP has the potential to be a cost-effective and readily available tool in localizing the SOZ by measuring postictal CBF changes.en_US
dc.identifier.citationLi, E. (2018). Post-ictal hypoperfusion detected by CT Perfusion (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/31909en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/31909
dc.identifier.urihttp://hdl.handle.net/1880/106627
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.facultyScience
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectpostictal
dc.subjecthypoperfusion
dc.subjectcomputed tomography
dc.subjectperfusion
dc.subjectcerebral blood flow
dc.subjectEpilepsy
dc.subject.classificationNeuroscienceen_US
dc.subject.classificationBiophysics--Medicalen_US
dc.subject.classificationMedicine and Surgeryen_US
dc.subject.classificationRadiologyen_US
dc.titlePost-ictal hypoperfusion detected by CT Perfusion
dc.typemaster thesis
thesis.degree.disciplineNeuroscience
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameMaster of Science (MSc)
ucalgary.item.requestcopytrue
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