PMC9638089_01
The patient's brain computed tomography results of the first hospitalization after trauma. (A,B) Two pieces of high-density signal were, respectively, in the bilateral temporal lobe and frontal lobe at the time of admission (arrows). (C) The continuity of the left orbital bone was interrupted (arrow). (D,E) The continuity of the right cranial parietal bone and temporal bone were interrupted (arrows). (F,G) The signal of lesion area displayed low-density in the bilateral temporal lobe and frontal lobe at the time of discharge (arrows).
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F1
The swelling of his head and face was obvious, especially on the right side, and he had a typical left raccoon eye (Supplementary Figure 1). The brain computed tomography (CT) on admission showed two parts of abnormal increased signal in the bilateral temporal lobe and frontal lobe, and they might be confused with hemorrhage (Figures 1A,B). In addition, there was discontinuity, respectively, in the left orbital bone, the right cranial parietal bone, and the cranial temporal bone (Figures 1C-E). The signal of the previous abnormal parts in the CT changed to low density, they might be manifestations of bleeding absorption (Figures 1F,G).
Results of preoperative and intraoperative imaging examination. (A) The brain computed tomography showed multiple pieces of low-density signal were in the left cerebral hemisphere (arrows). (B) The computed tomography angiography exhibited the M1 segment of the left middle cerebral artery (LMCA) was partially interrupted (arrow). (C) The angiography before the operation displayed that there was stratification in the M1 segment of the LMCA (arrow). (D) The angiography after the operation demonstrated the stratification disappeared after the 3.5*20 mm intracranial self-expanding stent had been released in the LMCA and the vascular morphology was significantly improved (arrow). The magnification of the white box were in the left lower corner of (B-D).
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F2
In the imaging examination, the brain CT displayed multiple pieces of decreased signal in the left cerebral hemisphere, this indicated the possibility of AIS (Figure 2A). The artery and angiography exhibited that the M1 segment of the left middle cerebral artery (LMCA) was partially interrupted, and distal blood flow reduced significantly (Figure 2B). The angiography showed there was dissection in the M1 segment of the LMCA (Figure 2C). During the operation, the 3.5*20 mm intracranial self-expanding stent was released, and the LMCA was completely reanalyzed (Figure 2D). Post-operative imaging showed no obvious abnormality, and the lesion gradually recovered (Supplementary Figures 2A,B).