Contrast staining post endovascular clot retrieval

Case contributed by Henry Knipe
Diagnosis certain


Left hemiparesis. Proceeded to angiography suite for mechanical thrombectomy followed by post-procedure CT.

Patient Data

Age: 65 years
Gender: Male

Post mechanical thrombectomy


Hyperdensity to the right caudate nucleus body and lentiform nucleus is compatible with contrast staining given history. No acute intracranial hemorrhage identified. Grey-white differentiation is preserved. Ventricular size, sulcal pattern and basal cisterns are normal for age. No significant mass effect. No midline shift.

24 hours later


Previously demonstrated hyperdensity of the right caudate body and lentiform nucleus likely related to contrast and has now significantly reduced. No convincing region of established cortical infarct identified. No acute intracranial hemorrhage or extra-axial collection. Ventricles are stable. No midline shift.

Case Discussion

Contrast staining typically appears as areas of hyperdensity mostly confined to grey matter (cortex and deep grey matter) and represent areas of blood-brain barrier breakdown secondary to ischemia with microvascular extravasation of contrast into the extracellular space. Typically such staining clears within the first 19-24 hours after the procedure. 

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