Presentation
Acute left-side body weakness. The patient was diagnosed with a right MCA infarction, and he underwent immediate thrombectomy.
Patient Data
A follow-up dual-energy CT of the brain was performed immediately after endovascular thrombectomy.
It showed cerebral gyriform hyperdensities within the right temporoparietal cortical region as well as within the right Sylvian fissure and interpeduncular cistern in both the iodine overlay map (IOM) and virtual monoenergetic non-contrast images (VNC).
Features favor iodinated contrast rather than acute subarachnoid hemorrhage.
Case Discussion
In following up on a patient with a stroke after mechanical thrombectomy, sometimes it can be challenging to differentiate between the extravasated contrast media, contrast staining, and bleeding. Hence, performing the dual-energy CT can help differentiate between them.
By doing further follow-up with plain CT, contrast media will disperse relatively quickly; however, the hemorrhage persists.
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