PubMed · 10926973
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L Robinson. 2000. Clototripsy?. https://doi.org/10.1161/01.str.31.8.2024
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The syndrome of the sinking skin flap (SSSF) has been described as one of the causes of neurological deficits after decompressive craniectomy We report a case of a 57-year-old woman with SSSF. Two years earlier, this patient, with no neurological deficits, underwent removal of the bone flap during treatment of an epidural abscess due to wound infection after a clipping operation for a ruptured aneurysm. The patient, who subsequently developed a sinking skin flap, gradually presented with gait disturbance and poor activity around 1 year before she came to our facility. On admission, neurological examination showed left hemiparesis and mild confusion. Cranioplasty with titanium mesh plate was performed. The cerebral blood flow (CBF) value in CT perfusion imaging in the symptomatic hemisphere increased from 23 to 31 cm3/100 g/min, and the value in the contralateral side increased from 37 to 41 cm3/100 g/min after cranioplasty. CT perfusion imaging after cranioplasty revealed the improvement of cerebral blood flow not only on the symptomatic side but also on the contralateral side. The patient recovered well and was discharged without hemiparesis and confusion 2 weeks after cranioplasty. As far as we know, this is the first reported case of SSSF examined with CT perfusion imaging before and after cranioplasty.
Endothelial dysfunction, the complex, multifaceted, pathologic product of various vasculotoxic agents or injuries, is an intermediate attractant phenotype of cardiovascular diseases that usually has a long and unpredictable natural history. Furthermore, endothelial dysfunction may not only represent a vascular disease marker, but actually may play an important pathogenetic role that leads to the progression of the disease and the unfavorable outcomes. Among these vascular diseases, cerebrovascular accidents, particularly stroke, clearly represent a paradigmatic example of the potential role of dysfunctional endothelium. Elevated blood pressure has long been recognized as one of the most important risk factors for stroke; other factors, however, seem to play an important role. Indeed, epidemiologic evidence suggests that, in spite of an improved control of blood pressure, the secular trends of stroke in well-controlled populations are increasing. In this brief review, we analyze current evidence suggesting that endothelial dysfunction can play a role in the pathogenesis of ischemic stroke.
Production of 17F (t1/2=65 s) in the form of [17F] F2 has been achieved using both the 20Ne(p,alpha)17F and 16O(d,n)17F reactions with 11 MeV protons and 6 MeV deuterons, respectively. Yields have proven suitable for subsequent radiosynthesis of the blood flow tracer, [17F]CH3F (>60 mCi in saline), currently in use for fast repetition human studies of regional cerebral blood flow with positron emission tomography. Thick target yields of 15 mCi /microA for protons and 44 mCi/microA for deuterons have been measured for [17F]F2.