Contrast staining post endovascular clot retrieval

Case contributed by Andrew Murphy


Suspected haemorrhagic transformation post endovascular clot retrieval

Patient Data

Age: 45 years

Hyperdensity within the right basal correlates with iodine on the iodine maps. This correlates with areas of loss of grey white matter differentiation on the initial non contrast head. It likely relates to contrast staining post DSA in regions of cerebral infarction. There is associated mass effect with effacement of the frontal horn of the right lateral ventricle. Slight midline shift of 2 mm towards the left.

No intracranial haemorrhage seen.

There is subtle loss of the grey-white matter differentiation in anterior aspect of the right temporal lobe and patchy hypodensities in the right frontal lobe, in keeping with areas of evolving infarction. Grey-white matter differentiation in the left cerebral hemisphere is normal. The M1 segment of the right middle cerebral artery now appears opacified on this non-dedicated study (opacified from recent DSA).

Case Discussion

Iodine maps and virtual non-contrast imaging via dual energy CT is an effective method in differentiating hemorrhagic transformation from iodinated contrast staining following interventional procedures such as endovascular clot retrieval.

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Case information

rID: 55512
Published: 11th Sep 2017
Last edited: 4th Nov 2017
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Princess Alexandra Hospital

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