Nonpulsatile cerebral perfusion in patient with acute neurological deficits

Yo Sik Kim, Oleg Y. Chernyshev, Andrei Alexandrov

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE - An extremely low pulsatile cerebral perfusion can result in a massive cerebral infarction and poor outcome. We report a patient who had complete recovery from initial neurological deficits in spite of nonpulsatile perfusion in the middle cerebral artery. METHODS - We used carotid duplex and transcranial Doppler to evaluate cerebral hemodynamics and the National Institutes of Health Stroke Scale (NIHSS) to score the neurological deficits. RESULTS - A 62-year-old man had a sudden chest pain and right hemispheric symptoms with NIHSS score of 18 on arrival. Carotid duplex showed no blood flow in the right common carotid artery. Transcranial Doppler showed a nonpulsatile waveform with slow antegrade flow in right middle cerebral artery. Chest CT angiography revealed type A aortic dissection. After surgical repair for the aortic dissection with brain retroperfusion, the patient had dramatic recovery from the initial neurological deficit, and normal pulsatile cerebral perfusion in the right carotid territory. CONCLUSIONS - Nonpulsatile cerebral perfusion points to a proximal source of arterial flow obstruction that may necessitate interventional treatment or surgery in order to restore brain perfusion and potentially reverse impending stroke.

Original languageEnglish (US)
Pages (from-to)1562-1564
Number of pages3
JournalStroke
Volume37
Issue number6
DOIs
StatePublished - Jun 1 2006
Externally publishedYes

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Pulsatile Flow
Perfusion
Stroke
Middle Cerebral Artery
National Institutes of Health (U.S.)
Dissection
Common Carotid Artery
Cerebral Infarction
Brain
Chest Pain
Thorax
Hemodynamics
Therapeutics
Computed Tomography Angiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Nonpulsatile cerebral perfusion in patient with acute neurological deficits. / Kim, Yo Sik; Chernyshev, Oleg Y.; Alexandrov, Andrei.

In: Stroke, Vol. 37, No. 6, 01.06.2006, p. 1562-1564.

Research output: Contribution to journalArticle

Kim, Yo Sik ; Chernyshev, Oleg Y. ; Alexandrov, Andrei. / Nonpulsatile cerebral perfusion in patient with acute neurological deficits. In: Stroke. 2006 ; Vol. 37, No. 6. pp. 1562-1564.
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