A case of chronic subdural hematoma demonstrating the epileptic focus at the area with sulcal hyperintensity on fluid-attenuated inversion recovery image

Sotaro Oshida; Yosuke Akamatsu; Yoshiyasu Matsumoto; Shinya Ishigame; Yasushi Ogasawara; Kenta Aso; Hiroshi Kashimura

doi:10.1016/j.radcr.2019.06.021

A case of chronic subdural hematoma demonstrating the epileptic focus at the area with sulcal hyperintensity on fluid-attenuated inversion recovery image

Radiol Case Rep. 2019 Jul 13;14(9):1109-1112. doi: 10.1016/j.radcr.2019.06.021. eCollection 2019 Sep.

Authors

Sotaro Oshida¹, Yosuke Akamatsu², Yoshiyasu Matsumoto¹, Shinya Ishigame¹, Yasushi Ogasawara¹, Kenta Aso¹, Hiroshi Kashimura¹

Affiliations

¹ Department of Neurosurgery, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, Iwate 024-8507, Kitakami, Iwate, Japan.
² Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.

Abstract

Although the sulcal hyperintensity on fluid-attenuated inversion recovery (FLAIR) images is detected in some chronic subdural hematoma (CSDH) cases, its clinical significance remains determined. A 77-year-old man with symptomatic CSDH presented with generalized tonic-clonic seizures at 9 days after surgery. ¹²³I-iomazenil -single photon emission computed tomography revealed transient reduction in cortical benzodiazepine receptors binding potential at the region corresponding to that of the sulcal hyperintensity on FLAIR images. Findings of sulcal hyperintensity on FLAIR imaging under the CSDH may have a relation with the cause of epileptic seizure.

Keywords: 123I-iomazenil; BRBP, benzodiazepine receptor binding potential; CSDH, chronic subdural hematoma; CSF, cerebrospinal fluid; CT, computed tomography; Chronic subdural hematoma; FLAIR, fluid-attenuated inversion recovery; IMZ, 123I-iomazenil; MRI, magnetic resonance imaging; SPECT; SPECT, single photon emission computed tomography; Symptomatic epilepsy.

Publication types

Case Reports