Hemorrhage or Ischemia? The Importance of 'Spotting' it Right

Neurocrit Care. 2015 Aug;23(1):113-5. doi: 10.1007/s12028-015-0113-1.

Abstract

Background: A 78-year-old woman was transferred directly to an ICU because of intracerebral hemorrhage. However, on careful review of the initial imaging, the likely diagnosis was ischemic stroke and reperfusion hemorrhage.

Methods: Case report was explained.

Results: The patient suffered significant reperfusion hemorrhage. A CT angiogram revealed contrast extravasation "spot sign" in the bed of the expanding hemorrhage and an occlusive thromboembolism distal to the initial ischemic insult.

Conclusion: In this case of embolic ischemic stroke with reperfusion hemorrhage, contrast extravasation "spot sign" was associated with hematoma expansion.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brain Ischemia / diagnostic imaging*
  • Cerebral Hemorrhage / diagnostic imaging*
  • Cerebral Hemorrhage / etiology
  • Female
  • Humans
  • Radiography
  • Reperfusion Injury / complications
  • Reperfusion Injury / diagnostic imaging*
  • Stroke / complications
  • Stroke / diagnostic imaging*