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To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00031.x Byline: Katja E. Wartenberg (1), Augusto Parra (1) Keywords: HHH therapy; reversible leukoencephalopathy; subarachnoid hemorrhage; perfusion computed tomography; vasospasm Abstract: ABSTRACT Background: Reversible leukoencephalopathy syndrome (RLS) is an acute neurological syndrome associated with altered mental status and visual disturbances described in patients with sudden elevations in systemic blood pressure and other medical conditions. In this process, neuroimaging studies usually demonstrate diffuse edema involving the subcortical structures of the posterior regions of the brain. Triple H (HHH) therapy is an established treatment for symptomatic vasospasm following subarachnoid hemorrhage (SAH). RLS has not been reported in the scientific literature as a complication of HHH therapy with perfusion computed tomography (CTP) imaging documentation. Case: A 73-year-old woman developed iatrogenic RLS during HHH therapy for SAH-related vasospasm. The computed tomography (CT) revealed bilateral parieto-occipital hypodensities. The CTP study showed increased cerebral blood volume and blood flow as well as decreased mean transit time in both parietal-occipital regions, which is compatible with vasogenic edema. Conclusion: The induction of hypertension as part of HHH therapy for SAH-related cerebral vasospasm may result in RLS. Therefore, it should be considered as a potentially reversible cause in the differential diagnosis of neurological deterioration in SAH patients while on HHH therapy. CTP study can offer an alternative for the assessment of this cerebrovascular syndrome. Author Affiliation: (1)From the Post Doc Clinical Fellow (KEW), and Assistant Professor of Neurology and Neurological Surgery(AP), Division of Stroke and Neurocritical Care, Columbia University, College of Physicians & Surgeons, Neurological Institute, 710 West 168th Street, New York, NY 10032. Article History: Received June 22, 2005, and in revised form October 14, 2005. Accepted for publication December 17, 2005. Article note: Address correspondence to Augusto Parra, MD, MPH, Assistant Professor of Neurology and Neurological Surgery, Division of Stroke and Neurocritical Care, Columbia University, College of Physicians & Surgeons, Neurological Institute, 710 West 168th Street, New York, NY 10032. E-mail: AP2138@columbia.edu.

Copyright of Revista Lasallista de Investigación is the property of Corporacion Universitaria Lasallista and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Virtual Universidad Católica del Norte is the property of Revista Virtual Universidad Catolica del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Virtual Universidad Católica del Norte is the property of Revista Virtual Universidad Catolica del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)