PMC3635684_01
a Cranial CT on admission shows a hyperdense left MCA. b Distal left MCA occlusion was confirmed by CT angiography. c CT follow-up 24 h after thrombolysis showed a frontoparietal MCA infarction. d, e MRI without signs of gross hemorrhagic transformation. f, g Extended superficial ecchymoses of the skin after thrombolysis under dabigatran.
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F1
CT scan showed early infarct signs in the left temporoparietal region, and a left hyperdense middle cerebral artery (MCA) sign (fig. 1a). CT angiography confirmed distal M1 occlusion (fig. 1b). The patient continued to improve functionally to an NIHSS of 5 within the next hours and CT follow-up the next day revealed an infarct in the anterior part of the MCA territory (fig. 1c). There was no sign of hemorrhagic transformation on MRI (fig. 1d, e), but the patient developed extended superficial ecchymoses of the whole body (fig. 1f, g), which gradually resolved without sequelae over two weeks.