PMC9427261_01
Noncontrast CT brain performed at the time of initial presentation, revealing established infarcts in the left MCA and ACA territories.
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CT angiography-circle of Willis scanning revealed extensive low attenuation in the left MCA and ACA territories, suggestive of extensive ischaemic infarction in these areas (Figure 1). Contrast angiography revealed diminutive M2 branches of the left MCA which appeared intact.
CT pulmonary angiogram performed on day 3 showing right-sided proximal segmental pulmonary embolism.
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The CTPA revealed extensive bilateral segmental and subsegmental pulmonary emboli, along with left lower lobe collapse and consolidation, with bilateral patchy ground-glass change (Figure 2).
Noncontrast CT brain performed on day 3, revealing haemorrhage in the ACA territory.
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Progress CT brain on day 3 showed petechial haemorrhage in the left frontoparietal MCA territory consistent with haemorrhagic transformation of affected area, with slightly increased mass effect and subfalcine herniation (Figure 3).