Resolution of "hyperdense" middle cerebral artery post tPA thrombolysis

Case contributed by Dr Chris O'Donnell

Presentation

Acute right hemiplegia, presented within 1 hour ro ED. Treated with tPA thrombolysis leading to complete resolution of symptoms.

Patient Data

Age: 85
Gender: Male
CT

CT at time of initial presentaion and at 24 hours as per protocol

Dense left MCA (distal M1) on the inital scan that resolves on the subsequent ie post tPA (60 HU to 36 HU) consistent with lysed blood clot. No signs of infarction including no loss of the "insular ribbon". No features of infarction on the subsequent scan nor hemorrhage.

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Case information

rID: 29163
Published: 7th May 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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