Focusing on Single CT Perfusion Quantitative Maps: Percheron’s Artery Stroke Detection

• Published in: Canadian journal of neurological sciences 2022-07, Vol.49 (4), p.600-602
• Main Authors: Cillotto, Tommaso, Furlanis, Giovanni, Buoite Stella, Alex, Lugnan, Carlo, Caruso, Paola, Pozzi Mucelli, Roberta, Naccarato, Marcello, Manganotti, Paolo
• Format: Article
• Language: English
• Subjects: Asymmetry; Cardiac arrhythmia; Case reports; Consciousness; Letters to the Editor: Published Article; Medical imaging; Neuroimaging; Respiratory failure; Stroke; Veins & arteries
• ISSN: 0317-1671; 2057-0155
• DOI: 10.1017/cjn.2021.173

CTP data were acquired and processed as previously described.5 In particular, CTP was reported as negative due to the absence of alterations in the core/penumbra summary map, which was calculated according to the Wintermark et al. asymmetry criteria.6 However, a subsequent analysis of single CTP maps, namely CBV, CBF, MTT, and TTP, revealed a bilateral symmetrical thalamic hypoperfusion in TTP, CBF, and MTT, without any CBV alteration. Due to the gravity of the clinical picture, the patient was then transferred to the intensive care unit, where he died for the severe respiratory failure. Besides the classical triad (vertical gaze palsy, consciousness alteration, and memory disorder), other signs and symptoms are reported in literature, including oculomotor and movement disorders, cerebellar ataxia, hemiplegia, and speech disturbances.2 Our case presented total anterior circulation syndrome (TACS) related symptoms, suggestive of infarct in the territory of the middle cerebral artery, which was excluded by the radiological assessment. [...]CTP assessment based only on the core/penumbra summary map was reported as negative, while a detailed analysis of single CTP parameters maps revealed bilateral symmetrical thalamic marked hypoperfusion in TTP, CBF, and MTT, but no CBV alteration (Figure 1).