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TCD Systolic Spikes in a Malignant MCA Infarct

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Abstract

Introduction

Malignant MCA infarction results in significant space occupying effect and intracranial pressure (ICP) increment. Due to the high mortality rate in such patients, the term malignant MCA infarction was coined.

Methods

We studied a patient who developed a sudden onset of slurred speech, right hemiplegia, and decreased level of arousal. Two days later CT scan showed a massive cerebral infarct, involving the left MCA territory.

Results

A transcranial Doppler exam showed a normal flow pattern in the right hemisphere, but in the left hemisphere systolic spikes without diastolic flow were observed in internal carotid artery, anterior cerebral artery, as well as in the MCA.

Conclusions

The pathophysiologic mechanisms leading to BD might asymmetrically begin in cerebral hemispheres in malignant MCA infarcts.

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Authors and Affiliations

  1. Hermanos Ameijeiras Hospital, Service of Neurology, Havana, Cuba

    Jesus Perez-Nellar & Claudio Scherle

  2. Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery, Havana, Cuba

    Calixto Machado

Authors
  1. Jesus Perez-Nellar
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  2. Claudio Scherle
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  3. Calixto Machado
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Corresponding author

Correspondence to Jesus Perez-Nellar.

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Perez-Nellar, J., Scherle, C. & Machado, C. TCD Systolic Spikes in a Malignant MCA Infarct. Neurocrit Care 11, 94–96 (2009). https://doi.org/10.1007/s12028-009-9216-x

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  • DOI: https://doi.org/10.1007/s12028-009-9216-x

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