PMC8412819_01
Non contrasted CT (A) and CT-Angiography (B) show a proximal occlusion of the right posterior cerebral artery (PCA) at P1-P2 junction (arrow) without signs for acute ischemic stroke or hemorrhage.
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Accordingly, urgent cerebral CT and CT-angiography (Figure 1) were done, which showed a proximal occlusion of the right posterior cerebral artery (PCA) at the P1-P2 junction without signs of established acute ischemic stroke or hemorrhage.
Digital subtraction angiography (A) before thrombectomy shows right P1-P2 occlusion (arrow), and (B) after thrombectomy shows near complete perfusion with TICI 2b.
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Thrombolysis in cerebral infarction (TICI) 2b was achieved as shown in (Figure 2).
CT follow up 24 hours after acute reperfusion therapies shows acute ischemic stroke in right PCA territory with substantial hemorrhagic transformation (arrow).
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The follow-up CT (Figure 3) revealed an acute large ischemic stroke in the whole territory of a right posterior cerebral artery (PCA) up to the thalamus with substantial hemorrhagic transformation in the shape of parenchymal hematoma type 1 (PH1).
Axial brain MRI images of diffusion-weighted imaging (A), apparent diffusion coefficient (B), and susceptibility-weighted imaging (C) sequences, show acute ischemic changes in the right PCA territory with hemorrhagic transformation.
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The patient was also taken for a magnetic resonance imaging (MRI) scan, which did not reveal any new findings (Figure 4).