Unique <scp>CT</scp> Perfusion Imaging in a Case of <scp>H</scp> a <scp>NDL</scp> : New Insight into <scp>H</scp> a <scp>NDL</scp> Pathophysiology and Vasomotor Principles of Cortical Spreading Depression

Abstract

The pattern of global left hemispheric hypoperfusion seen in this case of HaNDL supports a hypothesis of secondary oligemia induced by a hemispheric wave of cortical spreading depression (CSD). However, the extension of hypoperfusion to the right ACA territory represents a phenomenon not previously reported in this field. We speculate that the direct spread of CSD-induced vasomotor changes across the anomalous vasculature could account for this finding. This case provides a valuable contribution toward understanding HaNDL pathophysiology and in doing so may also yield broader implications regarding neurophysiological principles of CSD.