Internal and middle cartoid artery rethrombosis post clot retrieval
Follow up CT 2 hours post right terminal ICA, M1 and A1 clot retrieval which was performed 4.5 hours after symptom onset. Initial external CT not available.
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There is cytotoxic oedema of the right cerebral hemisphere with loss of grey-white matter differentiation and mild effacement of the right lateral ventricle, in keeping with acute MCA and ACA ischaemia, with sparing of the right PCA territory. The left ACA territory also shows loss of grey-white matter differentiation. No midline shift or uncal herniation. No hydrocephalus.
The right MCA and distal ICA is hyperdense suggesting re-thrombosis.
Hyperdensity within the medial right temporal lobe posterior to the hyperdense MCA.
Acute ischaemia in the right cerebral hemisphere involving the right MCA and ACA and left ACA territories. Hyperdense right MCA suggesting re-thrombosis.
Small hyperdensity in the medial right temporal lobe which may represent a focus of haemorrhagic transformation or contrast staining from the prior angiogram.
Re-thrombosis is a complication of clot retrival.
The patient died 2 days later.