Arterial spin-labeling magnetic resonance imaging for diagnosis of late seizure after stroke

Abstract

Background and purpose: Arterial spin labeling (ASL) is a non-invasive modality of magnetic resonance imaging (MRI) used to evaluate cerebral perfusion without a contrast agent. The usefulness of ASL for diagnosis in the acute phase of late seizure after stroke was evaluated.

Methods: Twelve consecutive patients diagnosed with late seizure after stroke were enrolled in this study. MRI including ASL was performed for each patient at the time of the emergency department visit. Eight of the patients underwent electroencephalography (EEG).

Results: All patients showed hyperperfusion around the stroke lesion on ASL. Only 6 patients showed high signal intensity along the cerebral cortex around the stroke lesion on diffusion-weighted imaging. The patients who underwent EEG showed slow activity, but paroxysmal discharges such as spikes or sharp waves were not observed.

Conclusions: ASL was able to reveal hyperperfusion and was of great diagnostic value in the peri-ictal phase of late seizure after stroke.

Keywords: Arterial spin labeling; Diffusion-weighted imaging; Hyperperfusion; Late seizure; Magnetic resonance imaging; Post-stroke epilepsy; Post-stroke seizure.