Evaluation of the Consistency of Peri-ictal Hemodynamic Findings Revealed by Capturing More Than 3 Seizures Using 1.5-Tesla Pseudo-continuous Arterial Spin Labeling Magnetic Resonance Perfusion Imaging with Triple Post-labeling Delays: Report of 3 Cases
5 affiliations
- 1Department of Neurosurgery, Hachisuga Hospital, Munakata, Fukuoka, Japan
- 2Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
- 3Department of Clinical Laboratory Medicine, Kyushu University Hospital, Fukuoka, Fukuoka, Japan
- 4Division of Medical Technology, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
- 5Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
Abstract
In the pathophysiological diagnosis of seizures in neuro-emergencies, the usefulness of arterial spin labeling perfusion imaging, which can be performed 24 hr a day, 7 days a week, in capturing peri-ictal hyperperfusion has been reported as a means of compensating for the limitations of electroencephalography, which is available only during regular hours. Herein, we retrospectively evaluated the consistency of arterial spin labeling findings in conjunction with electroencephalography findings in 3 patients with 3 or more seizures. Patients 1 and 2 both experienced 3 seizures and were transported outside of regular hours. On arterial spin labeling, consistent peri-ictal hyperperfusion was observed in the right posterior quadrant with a close anatomical relationship to the epileptogenic lesion in Patient 1 and in the right occipitotemporal lobe without an identifiable epileptogenic lesion in Patient 2. Subsequent electroencephalography failed to reveal any paroxysmal discharges. Patient 3 experienced 4 seizures. Electroencephalography performed immediately after the third seizure demonstrated ictal discharges in the right frontal region, while the other electroencephalography recordings showed paroxysmal discharges and rhythmic slow waves in the same region. In arterial spin labeling, hyperperfusion was observed in the right frontal lobe only during the second seizure, whereas hypoperfusion was observed in the same region during the other seizures. This pattern was likely attributable to an early transition from ictal hyperperfusion to postictal or interictal hypoperfusion, and was therefore considered a consistent arterial spin labeling finding. Although consistent peri-ictal hyperperfusion is commonly observed on arterial spin labeling, hypoperfusion may also be observed; as such, comprehensive evaluation, including electroencephalography findings, is required for accurate diagnosis.
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BibTeX
@article{morioka2026evaluation,
title = {{Evaluation of the Consistency of Peri-ictal Hemodynamic Findings Revealed by Capturing More Than 3 Seizures Using 1.5-Tesla Pseudo-continuous Arterial Spin Labeling Magnetic Resonance Perfusion Imaging with Triple Post-labeling Delays: Report of 3 Cases}},
author = {Takato MORIOKA and Takafumi SHIMOGAWA and Nobutaka MUKAE and Fumihito MUGITA and Satoshi INOHA and Kazuhisa KUWABARA and Masayuki YANAGIDA and Ayumi SAKATA and Kou MATSUMOTO and Hiroshi SHIGETO and Koji YOSHIMOTO},
journal = {NMC Case Report Journal},
year = {2026},
month = oct,
doi = {10.2176/jns-nmc.2026-0186},
url = {https://doi.org/10.2176/jns-nmc.2026-0186},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Evaluation of the Consistency of Peri-ictal Hemodynamic Findings Revealed by Capturing More Than 3 Seizures Using 1.5-Tesla Pseudo-continuous Arterial Spin Labeling Magnetic Resonance Perfusion Imaging with Triple Post-labeling Delays: Report of 3 Cases
AU - Takato MORIOKA
AU - Takafumi SHIMOGAWA
AU - Nobutaka MUKAE
AU - Fumihito MUGITA
AU - Satoshi INOHA
AU - Kazuhisa KUWABARA
AU - Masayuki YANAGIDA
AU - Ayumi SAKATA
AU - Kou MATSUMOTO
AU - Hiroshi SHIGETO
AU - Koji YOSHIMOTO
PY - 2026
DA - 2026/10/13
JO - NMC Case Report Journal
DO - 10.2176/jns-nmc.2026-0186
UR - https://doi.org/10.2176/jns-nmc.2026-0186
AB - In the pathophysiological diagnosis of seizures in neuro-emergencies, the usefulness of arterial spin labeling perfusion imaging, which can be performed 24 hr a day, 7 days a week, in capturing peri-ictal hyperperfusion has been reported as a means of compensating for the limitations of electroencephalography, which is available only during regular hours. Herein, we retrospectively evaluated the consistency of arterial spin labeling findings in conjunction with electroencephalography findings in 3 patients with 3 or more seizures. Patients 1 and 2 both experienced 3 seizures and were transported outside of regular hours. On arterial spin labeling, consistent peri-ictal hyperperfusion was observed in the right posterior quadrant with a close anatomical relationship to the epileptogenic lesion in Patient 1 and in the right occipitotemporal lobe without an identifiable epileptogenic lesion in Patient 2. Subsequent electroencephalography failed to reveal any paroxysmal discharges. Patient 3 experienced 4 seizures. Electroencephalography performed immediately after the third seizure demonstrated ictal discharges in the right frontal region, while the other electroencephalography recordings showed paroxysmal discharges and rhythmic slow waves in the same region. In arterial spin labeling, hyperperfusion was observed in the right frontal lobe only during the second seizure, whereas hypoperfusion was observed in the same region during the other seizures. This pattern was likely attributable to an early transition from ictal hyperperfusion to postictal or interictal hypoperfusion, and was therefore considered a consistent arterial spin labeling finding. Although consistent peri-ictal hyperperfusion is commonly observed on arterial spin labeling, hypoperfusion may also be observed; as such, comprehensive evaluation, including electroencephalography findings, is required for accurate diagnosis.
SN - 2188-4226
ER -