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(A), (B) Pre-thrombolysis magnetic resonance images show a high-intensity area on the diffusion-weighted image and an iso-intensity area in the left frontal lobe on fluid-attenuated inversion recovery. (C), (D) Distal middle cerebral artery (M2) occlusion without responsive artery stenosis between the common carotid artery and proximal middle cerebral artery (M1) is documented on magnetic resonance angiography.
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Subsequent brain magnetic resonance imaging (MRI) showed a high-intensity area in the left frontal lobe on diffusion-weighted imaging with distal M2 occlusion on magnetic resonance angiography (Fig. 1) and multiple parieto-occipital-dominant lobar cerebral microbleeding (CMB) on susceptibility-weighted imaging (Fig. 2).
Post-thrombolysis head computed tomographics show multiple thrombolysis-related lobar hemorrhages.
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Follow-up brain CT performed 24 hours after thrombolysis revealed multiple points of ICH in the right frontotemporal lobe and cerebellar hemisphere without neurologic deteriorations (Fig. 3).