PMC6140730_01
Cerebral CT scan showing spontaneous hyperdensity in the left middle cerebral artery proximal segment M1 (A), lentiform nucleus obscuration (B, arrow 1), loss of gray-white matter discrimination (B, arrow 2), and proximal occlusion of the left middle cerebral artery on CT angiography (C).. Notes: (A) Cerebral CT scan showing spontaneous hyperdensity in the left middle cerebral artery proximal segment M1 (white arrow). (B) Proximal occlusion of the left middle cerebral artery on CT angiography (white arrow).. Abbreviation: CT, computed tomography.
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A computed tomography (CT) scan of the brain showed early signs of acute cerebral infarction in the left MCA territory (Figure 1A and B). Program Early CT Score (ASPECTS) was 8. Proximal thromboembolic occlusion of the left MCA was confirmed by cerebral CT angiography (Figure 1C).
Initial left internal carotid angiogram (lateral [A], and anteroposterior [B] views) showing proximal occlusion of the left middle cerebral artery (white arrow), lack of perfusion in the respective territory, and collateral flow from the left anterior cerebral artery through leptomeningeal anastomoses (black arrows).
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Alameda, CA, USA) was placed in the left internal carotid artery via the femoral artery. Angiography showed persistent occlusion of the proximal segment (M1) of the left MCA (Figure 2).
The 6 mm red clot removed from left middle cerebral artery following endovascular thrombectomy.
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A 6-mm red clot was taken out from between the stent retriever and the aspiration catheter (Figure 3).
Left internal carotid artery angiogram (lateral [A], and anteroposterior [B] views) showing recanalization (Thrombolysis in Cerebral Infarction [TICI] scale grade IIb), and slight vasospasm (white arrow) of the left middle cerebral artery following mechanical thrombectomy.
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A slight spasm was observed on the proximal segment (M1) (Figure 4).
Control cerebral CT-scan performed 24 hours after reperfusion therapies showing a left lenticulostriate (A, B) and caudate (C) infarct (white arrows).. Abbreviation: CT, computed tomography.
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The NIHSS score immediately decreased to 3 and then to 1 by the 24-hour assessment with limited infarction of the corpus striatum on the control CT scan (Figure 5).