Reperfusion seizures: a manifestation of cerebral reperfusion injury after administration of recombinant tissue plasminogen activator for acute ischemic stroke.
Reperfusion seizures: a manifestation of cerebral reperfusion injury after administration of recombinant tissue plasminogen activator for acute ischemic stroke.
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DOI：
10.1016/j.jstrokecerebrovasdis.2007.07.007
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发表时间：
2007-11-01
期刊：
影响因子：
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通讯作者：
Ramirez, Mark Allan N
中科院分区：
文献类型：
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作者：
Hafeez, Faizan;Razzaq, Mohammad A;Ramirez, Mark Allan N
再灌注损伤在医学文献中有很好的描述；脑再灌注损伤通常与血管外科手术有关，如颈动脉内膜切除术和支架置入术。脑再灌注损伤可表现为血脑屏障破坏、皮质激惹和癫痫发作。急性缺血性脑卒中溶栓治疗后，脑再灌注引起的癫痫发作尚未被记录或报道。我们报告了一位在卒中症状出现3小时内静脉注射重组组织型纤溶酶原激活剂的患者，并在重组组织型纤溶酶原激活剂使用20分钟内出现持续的原发性运动癫痫发作的新发症状。这些癫痫发作起源于与急性脑缺血相同的区域，发生在预期的脑再灌注期间。在这篇文章中，我们描述了一个病例报告，然后讨论了可能作为脑再灌注损伤表现的再灌注癫痫发作的病理生理学和机制。
Reperfusion injury has been well described in medical literature; cerebral reperfusion injury is commonly seen in association with vascular surgical procedures such as carotid endarterectomies and stent placement procedures. Cerebral reperfusion injury can manifest as blood-brain barrier breakdown, cortical irritability, and epileptic seizures. Seizures induced by cerebral reperfusion have not been documented or reported after thrombolytic therapy for acute ischemic stroke. We report a patient who received intravenous recombinant tissue plasminogen activator within 3 hours of stroke symptom onset and developed the new-onset symptom of continuous, primary motor seizure activity within 20 minutes of recombinant tissue plasminogen activator administration. These epileptic seizures originated in the same area as the acute brain ischemia and occurred during the anticipated period of cerebral reperfusion. In this article we describe a case report and then discuss the pathophysiology and mechanisms that may underlie reperfusion epileptic seizures as a manifestation of cerebral reperfusion injury.