0
May 2012, Vol 69, No. 5 >

Full Content is available to subscribers

Subscribe/Learn More
Images in Neurology | May 2012

Severe Decrease in Cerebral Blood Volume, Recanalization, and Hemorrhagic Transformation After Thrombolysis

Tae-Hee Cho, MD; Laura Mechtouff, MD; Laurent Derex, MD, PhD; Marc Hermier, MD, PhD; Norbert Nighoghossian
Arch Neurol. 2012;69(5):666. doi:10.1001/archneurol.2011.2327.
Text Size: A A A
Published online
Article
Figures
References
Comments

Extract

A 70-year-old man with atrial fibrillation was admitted to our hospital for right-sided hemiplegia and aphasia (with a National Institutes of Health Stroke Scale score of 17). Imaging features are summarized in the Figure; notably, perfusion magnetic resonance imaging, using dynamic susceptibility contrast, showed a severe decrease in cerebral blood volume (CBV) within the left anterior cerebral artery territory. Intravenous thrombolysis, administered 175 minutes after the onset of symptoms, failed to improve clinical status. A thrombectomy was scheduled but was eventually cancelled after witnessing recanalization of the left anterior cerebral artery during angiography. The left middle cerebral artery had features suggestive of a chronic occlusion (extensive collateral circulation from perforators and the middle meningeal artery, and no diffusion anomaly in this territory) and was not treated. A fatal hemorrhage within the area of very low CBV occurred 12 hours after thrombolysis, with diffuse subarachnoid and intraventricular extension.
Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

Figure. Magnetic resonance imaging scan of diffusion lesion in the left anterior cerebral artery (ACA) territory (A), collapse of blood vessels (ie, reduction in cerebral blood volume) in the left ACA territory (B), and hypoperfusion on time-to-peak map within the left ACA and the left middle cerebral artery (MCA) territories (C). D, Angiograph showing ACA occlusion (arrow) and collateral vessels suggestive of a chronic MCA occlusion (arrowheads). E, Angiograph showing ACA recanalization (arrow). F, Follow-up computed tomographic scan.

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Severe decrease in cerebral blood volume, recanalization, and hemorrhagic transformation after thrombolysis.
Arch Neurol 2012;;69(5):666-7.
Perfusion computed tomography-guided intravenous thrombolysis for acute ischemic stroke beyond 4.5 hours: a case-control study.
Cerebrovasc Dis 2012;;34(1):31-7.
Jobs

More Listings at
JAMACareerCenter.com >

JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Resolution

Users' Guides to the Medical Literature
Clinical Scenario

All results at
JAMAevidence.com >

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems