Presentation
Acute right hemiplegia treated within 3 hours by IV tPA. Marked worsening of hemiplegia and reduced conscious state about 6 hours later.
Patient Data
Age: 70 years
Gender: Male
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CTB performed within 1 hour of hemiplegia onset at 9.00am
Hyperdense right MCA without loss of grey white differentiation. No hemorrhage could be seen.
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Large right cerebral hematoma with intraventricular extension. Hyperdense R MCA is no longer present.
Case Discussion
Although tPA (tissue plasminogen activator) thrombolysis can lead to substantial clinical improvement in MCA occlusion there is always a risk of hemorrhage