{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:56:54Z","timestamp":1762865814321},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2001,3]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Fatal cerebral herniation is a common complication of large (\u201cmalignant\u201d) middle cerebral artery infarcts but has not been reported in unilateral anterior cerebral artery (ACA) infarction.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Case Description<\/jats:italic>\n            \u2014We report a 47-year-old woman who developed an acute left hemiparesis during an attack of migraine. Cranial CT (CCT) was normal but demonstrated narrow external cerebrospinal fluid compartments. Transcranial Doppler sonography was compatible with occlusion of the right ACA. Systemic thrombolytic therapy with tissue plasminogen activator was initiated 105 minutes after symptom onset. Follow-up CCT 24 hours after treatment revealed subtotal ACA infarction with hemorrhagic conversion. Two days later, the patient suddenly deteriorated with clinical signs of cerebral herniation, as confirmed by CCT. An extended right hemicraniectomy was immediately performed. Within 6 months, the patient regained her ability to walk but remained moderately disabled.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014This is the first reported case of unilateral ACA infarct leading to almost fatal cerebral herniation. Narrow external cerebrospinal fluid compartments in combination with early reperfusion, hemorrhagic transformation, and additional dysfunction of the blood-brain barrier promoted by tissue plasminogen activator and migraine may have contributed to this unusual course.\n          <\/jats:p>","DOI":"10.1161\/01.str.32.3.649","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"649-651","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Transtentorial Herniation After Unilateral Infarction of the Anterior Cerebral Artery"],"prefix":"10.1161","volume":"32","author":[{"given":"Stefanie","family":"Leistner","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Stroke Unit, Universita\u0308tsklinikum Benjamin Franklin, Freie Universita\u0308t Berlin, Berlin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friedrich","family":"Boegner","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Stroke Unit, Universita\u0308tsklinikum Benjamin Franklin, Freie Universita\u0308t Berlin, Berlin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Marx","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Stroke Unit, Universita\u0308tsklinikum Benjamin Franklin, Freie Universita\u0308t Berlin, Berlin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Christian","family":"Koennecke","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Stroke Unit, Universita\u0308tsklinikum Benjamin Franklin, Freie Universita\u0308t Berlin, Berlin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1996.00550040037012"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332401"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.2.287"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1994.81.1.0093"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000015843"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.30.11.2280"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.65.1.1"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.8.8042219"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.212.2.r99au16307"},{"key":"e_1_3_1_10_2","first-page":"377","volume":"126","year":"1995","unstructured":"Okajima K, Abe H, Binder BR. Endothelial cell injury induced by plasmin in vitro. J Lab Clin Med. 1995;126:377\u2013384.","journal-title":"J Lab Clin Med"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-199605000-00003"},{"key":"e_1_3_1_12_2","unstructured":"Deleted in proof."},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1990.00530040114027"},{"key":"e_1_3_1_14_2","first-page":"1308","volume":"2","year":"1985","unstructured":"Meyer JS, Hata T, Imai A, Zetusky WJ. Migraine and intracranial swelling. Lancet. 1985;2:1308\u20131309.","journal-title":"Lancet"},{"key":"e_1_3_1_15_2","first-page":"159","volume":"5","year":"1993","unstructured":"Moskowitz MA, Macfarlane R. Neurovascular and molecular mechanisms in migraine headaches. Cerebrovasc Brain Metab Rev. 1993;5:159\u2013177.","journal-title":"Cerebrovasc Brain Metab Rev"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.1995.1504277.x"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(96)80226-1"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.32.3.649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:24:52Z","timestamp":1715552692000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.32.3.649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,3]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2001,3]]}},"alternative-id":["10.1161\/01.STR.32.3.649"],"URL":"https:\/\/doi.org\/10.1161\/01.str.32.3.649","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,3]]},"assertion":[{"value":"2000-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-11-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-03-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}